{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:43:11Z","timestamp":1753879391734,"version":"3.41.2"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T00:00:00Z","timestamp":1641513600000},"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":["Pediatric Transplantation"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This retrospective multicenter long\u2010term cohort study investigates de novo donor\u2010specific HLA antibodies (dnDSA) impact on allograft survival in pediatric kidney transplantation (KTx), depending on allograft function at dnDSA detection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seventy patients with dnDSA screening in the context of acute allograft dysfunction (AAD) (&gt;50% serum creatinine increase) or routine follow\u2010up were included during a 20\u2010year period. Number of dnDSA specificities and HLA total mean fluorescence intensity (MFI\u2010sum) were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median follow\u2010up time was 8.6\u00a0years. Among the 22 dnDSA+ patients, 8 patients presented AAD. Compared with dnDSA\u2212 patients, allograft survival was shorter only in dnDSA+\/AAD+ patients, regardless of dnDSA detection during the 5\u2010year post\u2010transplant period (9 patients) or later (13 patients) (log rank <jats:italic>p<\/jats:italic> &lt; .001 and <jats:italic>p<\/jats:italic> &lt; .001, respectively). One dnDSA+\/AAD\u2212, 7 dnDSA+\/AAD+, and 5 dnDSA\u2212 patients lost their allograft. Allograft survival was shorter in dnDSA+\/AAD+ patients compared with the 16 dnDSA\u2212\/AAD+ patients (log rank <jats:italic>p<\/jats:italic> &lt; .001) but did not differ between dnDSA+\/AAD\u2212 and dnDSA\u2212\/AAD\u2212 patients (log rank <jats:italic>p<\/jats:italic> = .157). dnDSA+\/AAD+ and dnDSA\u2212\/AAD+ patients presented higher risk of allograft failure compared with the other patient groups after adjustment for recipient age at KTx, donor type, and incidence of delayed graft function (HR 11.322, 95% CI 3.094\u201341.429, <jats:italic>p<\/jats:italic> &lt; .001). Concurrent MFI\u2010sum &gt;10 000 and multiple dnDSA specificities were more significantly associated with AAD, compared with each factor separately (<jats:italic>p<\/jats:italic> &lt; .001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In pediatric KTx, AAD shortens allograft survival in dnDSA+ patients, regardless of dnDSA time detection, and is commonly observed when high MFI\u2010sum concurs with multiple dnDSA specificities. dnDSA without AAD incidence does not determinately affect allograft survival.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14221","type":"journal-article","created":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T08:05:36Z","timestamp":1641542736000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of de novo donor\u2010specific HLA antibodies on pediatric kidney transplant prognosis in patients with acute declined or stable allograft function"],"prefix":"10.1111","volume":"26","author":[{"given":"Asimina","family":"Fylaktou","sequence":"first","affiliation":[{"name":"Immunology Department National Peripheral Histocompatibility Center Hippokratio General Hospital of Thessaloniki  Thessaloniki Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3638-5179","authenticated-orcid":false,"given":"Vasiliki","family":"Karava","sequence":"additional","affiliation":[{"name":"1st Department of Pediatrics Pediatric Nephrology Unit Aristotle University of Thessaloniki Hippokratio General Hospital of Thessaloniki  Thessaloniki Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angeliki","family":"Vittoraki","sequence":"additional","affiliation":[{"name":"Immunology Department National Tissue Typing Center General Hospital of Athens \"G.Gennimatas\"  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Argyroula","family":"Zampetoglou","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology Department Panagiotis &amp; Aglaia Kyriakou Children's Hospital  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianthi","family":"Papachristou","sequence":"additional","affiliation":[{"name":"Immunology Department National Peripheral Histocompatibility Center Hippokratio General Hospital of Thessaloniki  Thessaloniki Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaos","family":"Antoniadis","sequence":"additional","affiliation":[{"name":"Solid Organ Transplantation Center Aristotle University of Thessaloniki Hippokratio General Hospital of Thessaloniki  Thessaloniki Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aliki","family":"Iniotaki","sequence":"additional","affiliation":[{"name":"Immunology Department National Tissue Typing Center General Hospital of Athens \"G.Gennimatas\"  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andromach","family":"Mitsioni","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology Department Panagiotis &amp; Aglaia Kyriakou Children's Hospital  Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikoleta","family":"Printza","sequence":"additional","affiliation":[{"name":"1st Department of Pediatrics Pediatric Nephrology Unit Aristotle University of Thessaloniki Hippokratio General Hospital of Thessaloniki  Thessaloniki Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,1,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2017.09.009"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-2775"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1314376"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2005050463"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2012.81"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2012.04251.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-020-04474-x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13079"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2012070663"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12859"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-012-2101-4"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.12707"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfy077"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13700"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-017-3772-7"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3046.2000.00075.x"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.12247"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2012.04013.x"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-019-04377-6"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13721"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13705"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2019.04.011"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2019.01.033"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3182139da1"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002310"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/1747030"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/tri.13325"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2006.01503.x"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2012.190"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3182543950"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.14221","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/petr.14221","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.14221","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T07:55:43Z","timestamp":1745999743000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.14221"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,7]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1111\/petr.14221"],"URL":"https:\/\/doi.org\/10.1111\/petr.14221","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"type":"print","value":"1397-3142"},{"type":"electronic","value":"1399-3046"}],"subject":[],"published":{"date-parts":[[2022,1,7]]},"assertion":[{"value":"2021-03-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14221"}}