{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T22:30:49Z","timestamp":1783809049856,"version":"3.55.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T00:00:00Z","timestamp":1725926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Redes de Investigaci\u00f3n Cooperativa Orientadas a Resultados en Salud","award":["RD21\/0005\/0003"],"award-info":[{"award-number":["RD21\/0005\/0003"]}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["ICI21\/00 049"],"award-info":[{"award-number":["ICI21\/00 049"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009091","name":"Fundaci\u00f3 Catalana de Trasplantament","doi-asserted-by":"publisher","award":["2022"],"award-info":[{"award-number":["2022"]}],"id":[{"id":"10.13039\/501100009091","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Sociedad Espa\u00f1ola de Trasplante","award":["2023"],"award-info":[{"award-number":["2023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,28]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Renal transplant recipients with donor-specific anti-HLA antibodies are at an increased risk of antibody-mediated rejection (ABMR). Early protocolized renal biopsies may serve as a strategy to improve diagnosis in this patient population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We evaluated 155 highly sensitized renal transplant recipients with cPRA class I\u00a0+\u00a0II &amp;gt;90% pre-transplant from 2015 to 2022. Patients with protocol biopsies within the first 2 weeks post-transplant were included.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 122 patients were included in the study. Of these, 13 (10.6%) were diagnosed with very early antibody-mediated rejection (veABMR) within the first 2 weeks post-transplant. This corresponds to 52% (13\/25 patients) of all ABMR cases reported during the follow-up of this population. The graft survival rates at 1 and 3 years were significantly lower in patients with veABMR (P\u00a0&amp;lt;\u00a0.001) compared with patients without rejection in the early protocol biopsy. In terms of severity, the veABMR cohort exhibited a hazard ratio (HR) of 10.33 (95% confidence interval 3.23\u201333.06, P\u00a0&amp;lt;\u00a0.001) for graft failure. The presence of donor-specific antibodies class II on the day of transplantation and a higher percentage of eplet mismatch (EpMM), particularly EpMM DQA1, correlated with the development of veABMR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Early protocol biopsies play a pivotal role in the early detection of veABMR in high-risk immunological patients. Patients with veABMR face significant risks of graft loss, despite early treatment of rejection.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ndt\/gfae186","type":"journal-article","created":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T05:54:05Z","timestamp":1726034045000},"page":"577-587","source":"Crossref","is-referenced-by-count":5,"title":["Antibody-mediated rejection diagnosed in early protocol biopsies in high immunological risk kidney transplant recipients"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1100-5758","authenticated-orcid":false,"given":"Carolt","family":"Arana","sequence":"first","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation. Institut Cl\u00ednic de Nefrologia i Urologia (ICNU) , Hospital Cl\u00ednic de Barcelona, Barcelona ,","place":["Spain"]},{"name":"Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundaci\u00f3 de Recerca Clinic Barcelona-Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (FRCB-IDIBAPS) , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyn","family":"Hermida","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation. Institut Cl\u00ednic de Nefrologia i Urologia (ICNU) , Hospital Cl\u00ednic de Barcelona, Barcelona ,","place":["Spain"]},{"name":"Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundaci\u00f3 de Recerca Clinic Barcelona-Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (FRCB-IDIBAPS) , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8737-5005","authenticated-orcid":false,"given":"Jordi","family":"Rovira","sequence":"additional","affiliation":[{"name":"Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundaci\u00f3 de Recerca Clinic Barcelona-Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (FRCB-IDIBAPS) , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"Caro","sequence":"additional","affiliation":[{"name":"Department of Immunology, Centre de Diagn\u00f2stic Biom\u00e8dic, Hospital Cl\u00ednic de Barcelona , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Cucchiari","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation. Institut Cl\u00ednic de Nefrologia i Urologia (ICNU) , Hospital Cl\u00ednic de Barcelona, Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Bel\u00e9n","family":"Larque","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hospital Cl\u00ednic de Barcelona , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"Palou","sequence":"additional","affiliation":[{"name":"Department of Immunology, Centre de Diagn\u00f2stic Biom\u00e8dic, Hospital Cl\u00ednic de Barcelona , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Torres","sequence":"additional","affiliation":[{"name":"Department of Immunology, Centre de Diagn\u00f2stic Biom\u00e8dic, Hospital Cl\u00ednic de Barcelona , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5940-8962","authenticated-orcid":false,"given":"Enrique","family":"Montagud-Marrahi","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation. Institut Cl\u00ednic de Nefrologia i Urologia (ICNU) , Hospital Cl\u00ednic de Barcelona, Barcelona ,","place":["Spain"]},{"name":"Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundaci\u00f3 de Recerca Clinic Barcelona-Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (FRCB-IDIBAPS) , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Cuadrado-P\u00e1yan","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation. 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Institut Cl\u00ednic de Nefrologia i Urologia (ICNU) , Hospital Cl\u00ednic de Barcelona, Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gast\u00f3n","family":"Pi\u00f1eiro","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation. Institut Cl\u00ednic de Nefrologia i Urologia (ICNU) , Hospital Cl\u00ednic de Barcelona, Barcelona ,","place":["Spain"]},{"name":"Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Fundaci\u00f3 de Recerca Clinic Barcelona-Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (FRCB-IDIBAPS) , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignacio","family":"Revuelta","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation. 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