{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:11:19Z","timestamp":1787242279056,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T00:00:00Z","timestamp":1551225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Both donor\u2010specific antibodies (DSA) and anti\u2010angiotensin II type 1 receptor antibodies (AT1R\u2010abs) have been associated with poor graft outcomes after kidney transplantation (KT). We aimed to understand the impact of pretransplant AT1R\u2010abs with or without concomitant DSA on KT outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seventy\u2010six patients transplanted in 2009 were studied. DSA (MFI\u2009&gt;\u20091000) and\/or AT1R\u2010abs (&gt;10UI) were detected by solid\u2010phase assays in pre\u2010KT sera. Multivariable Cox regression models were used to determine independent predictors of outcomes: acute rejection (AR) and graft failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At transplant, 48 patients were AT1R\u2010abs (\u2212)\/DSA (\u2212), 12 AT1R\u2010abs (+)\/DSA (\u2212), 9 AT1R\u2010abs (\u2212)\/DSA (+) and 7 AT1R\u2010abs (+)\/DSA (+). Incidence of acute rejection at 1\u2010year increased from 6% in AT1R\u2010abs (\u2212)\/DSA (\u2212), to 35% in AT1R\u2010abs (+)\/DSA (\u2212), 47% in AT1R\u2010abs (\u2212)\/DSA (+) and 43% in AT1R\u2010abs (+)\/DSA (+) (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;\u20090.001). No difference in DSA strength and C1q\u2010binding ability was observed between AT1R\u2010abs (\u2212) \/DSA (+) and AT1R\u2010abs (+)\/DSA (+) patients. Graft survival at 6\u2010years was the lowest in AT1R\u2010abs (+)\/DSA (+) (57%), followed by AT1R\u2010abs (+)\/DSA (\u2212) (67%), and higher in AT1R\u2010abs (\u2212)\/DSA (\u2212) (94%) and AT1R\u2010abs (\u2212)\/DSA (+) (89%) patients (\n                      <jats:italic>P<\/jats:italic>\n                      =\u20090.012). AT1R\u2010abs (+)\/DSA (\u2212) (HR\u2009=\u20096.41, 95% CI: 1.43\u201328.68;\n                      <jats:italic>P<\/jats:italic>\n                      =\u20090.015) and AT1R\u2010abs (+)\/DSA (+) (HR\u2009=\u20097.75, 95% CI: 1.56\u201338.46;\n                      <jats:italic>P<\/jats:italic>\n                      =\u20090.012) were independent predictors of graft failure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Acute rejection incidence and graft failure were associated with both DSA and AT1R\u2010abs. These results demonstrate a proper negative effect of AT1R\u2010abs on graft outcomes, besides a synergistic one with DSA. Pretransplant AT1R\u2010abs should be acknowledged to better stratify patients\u2019 immunological risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nep.13239","type":"journal-article","created":{"date-parts":[[2018,2,16]],"date-time":"2018-02-16T08:16:40Z","timestamp":1518769000000},"page":"347-356","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Deleterious effect of anti\u2010angiotensin II type 1 receptor antibodies detected pretransplant on kidney graft outcomes is both proper and synergistic with donor\u2010specific anti\u2010HLA antibodies"],"prefix":"10.1111","volume":"24","author":[{"given":"Jorge","family":"Malheiro","sequence":"first","affiliation":[{"name":"Nephrology and Kidney Transplantation Department Hospital de Santo Ant\u00f3nio, Centro Hospitalar do Porto  Porto Portugal"},{"name":"Unit for Multidisciplinary Investigation in Biomedicine (UMIB)  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Tafulo","sequence":"additional","affiliation":[{"name":"Centro do Sangue e Transplanta\u00e7\u00e3o do Porto, Instituto Portugu\u00eas do Sangue e Transplanta\u00e7\u00e3o  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leon\u00eddio","family":"Dias","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplantation Department Hospital de Santo Ant\u00f3nio, Centro Hospitalar do Porto  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"La Salete","family":"Martins","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplantation Department Hospital de Santo Ant\u00f3nio, Centro Hospitalar do Porto  Porto Portugal"},{"name":"Unit for Multidisciplinary Investigation in Biomedicine (UMIB)  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplantation Department Hospital de Santo Ant\u00f3nio, Centro Hospitalar do Porto  Porto Portugal"},{"name":"Unit for Multidisciplinary Investigation in Biomedicine (UMIB)  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idalina","family":"Beir\u00e3o","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplantation Department Hospital de Santo Ant\u00f3nio, Centro Hospitalar do Porto  Porto Portugal"},{"name":"Unit for Multidisciplinary Investigation in Biomedicine (UMIB)  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ant\u00f3nio","family":"Castro\u2010Henriques","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplantation Department Hospital de Santo Ant\u00f3nio, Centro Hospitalar do Porto  Porto Portugal"},{"name":"Unit for Multidisciplinary Investigation in Biomedicine (UMIB)  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ant\u00f3nio","family":"Cabrita","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplantation Department Hospital de Santo Ant\u00f3nio, Centro Hospitalar do Porto  Porto 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