{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T13:22:25Z","timestamp":1788355345455,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,8,24]],"date-time":"2017-08-24T00:00:00Z","timestamp":1503532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HLA"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:p>The role of <jats:italic>de novo<\/jats:italic> donor\u2010specific anti\u2010human leukocyte antigen (anti\u2010<jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>) antibodies (<jats:styled-content style=\"fixed-case\">dnDSA<\/jats:styled-content>) within the pathways leading to graft failure remains not fully understood. We investigated 56 patients who were transplanted between 2002 and 2014 with kidney graft failure (cases), for a possible association of development of <jats:styled-content style=\"fixed-case\">dnDSA<\/jats:styled-content> with graft failure. The 56 patients with failed transplants were matched with 56 patients with a functioning graft at present for the variables deceased or living donor, transplant number, transplant year, recipient age and gender, donor age and gender, dialysis vintage time, transplant induction therapy. All patients had at least one serum collected 1 year before failure (in cases) or end of follow\u2010up (in controls). Cases and controls were very well\u2010matched in several baseline characteristics. Post\u2010transplant anti\u2010<jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content> antibodies were found in 84% of cases and only 36% of controls (<jats:italic>P<\/jats:italic> &lt; .001), with 54% of cases and 16% of controls (<jats:italic>P<\/jats:italic> &lt; .001) having <jats:styled-content style=\"fixed-case\">dnDSA<\/jats:styled-content> at time of detection. Chronic active antibody\u2010mediated rejection was significantly more common (<jats:italic>P<\/jats:italic> &lt; .001) in patients with <jats:styled-content style=\"fixed-case\">dnDSA<\/jats:styled-content> (61% vs 12%), in 53 (47%) patients that had at least one graft biopsy performed during follow\u2010up. <jats:styled-content style=\"fixed-case\">dnDSA<\/jats:styled-content> was a significant risk factor (odds ratio [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>] = 6.06; <jats:italic>P<\/jats:italic> = .003) for graft failure in a multivariable conditional logistic regression model. <jats:styled-content style=\"fixed-case\">dnDSA<\/jats:styled-content> as a time\u2010dependent variable, was also an independent predictor [hazard ratio (HR) = 2.46; <jats:italic>P<\/jats:italic> = .002] of graft failure in a multivariable Cox regression analysis. In both statistical approaches, only <jats:styled-content style=\"fixed-case\">dnDSA\u2010II<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> = 11.90; <jats:italic>P<\/jats:italic> = .006) (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> = 2.30; <jats:italic>P<\/jats:italic> = .014) was significantly associated with graft failure. Post\u2010transplant <jats:styled-content style=\"fixed-case\">dnDSA<\/jats:styled-content> was clearly associated with graft loss, particularly if against <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content> class <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> antigens. <jats:styled-content style=\"fixed-case\">dnDSA<\/jats:styled-content> detection should be a tool for post\u2010transplant monitoring of kidney graft recipients, allowing for the identification of those with a higher risk of graft failure.<\/jats:p>","DOI":"10.1111\/tan.13111","type":"journal-article","created":{"date-parts":[[2017,8,4]],"date-time":"2017-08-04T12:16:44Z","timestamp":1501849004000},"page":"267-275","source":"Crossref","is-referenced-by-count":14,"title":["Role of <i>de novo<\/i> donor\u2010specific anti\u2010<scp>HLA<\/scp> antibodies in kidney graft failure: A case\u2010control study"],"prefix":"10.1111","volume":"90","author":[{"given":"A.","family":"Castro","sequence":"first","affiliation":[{"name":"Nephrology and Kidney Transplantation Department, Hospital de Santo Ant\u00f3nio Centro Hospitalar do Porto  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9625-5889","authenticated-orcid":false,"given":"J.","family":"Malheiro","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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3911-0245","authenticated-orcid":false,"given":"S.","family":"Tafulo","sequence":"additional","affiliation":[{"name":"Centro do Sangue e Transplanta\u00e7\u00e3o do Porto  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","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":"L. S.","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":"I.","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":"I.","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":"A.","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":"A.","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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