{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T20:28:59Z","timestamp":1740169739362,"version":"3.37.3"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Foundation for Science and Technology","doi-asserted-by":"crossref","award":["Fcomp-01-0124-FEDER-015896"],"award-info":[{"award-number":["Fcomp-01-0124-FEDER-015896"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2014]]},"abstract":"<jats:p><jats:italic>Introduction<\/jats:italic>. Posttransplantation allosensitization prevalence and effect on kidney grafts outcomes remain unsettled.<jats:italic>Methods<\/jats:italic>. Between 2007 and 2012, 408 patients received a primary kidney graft (with 68 patients also receiving a pancreas graft) after a negative cytotoxic crossmatch. All patients had a pretransplant negative anti-HLA screening and 0% panel reactive antibodies. We analyzed retrospectively the results of anti-HLA antibodies screening by Luminex assay, performed between 6 and 24 months after transplant, and searched for the risk factors for antibody positivity and its impact on kidney graft outcomes.<jats:italic>Results<\/jats:italic>. Anti-HLA antibodies prevalence at 6 months was 17.4%. Previous steroid-insensitive acute rejection was the only risk factor for both anti-HLA classes detected antibodies. Antithymocyte globulin induction was also a risk factor for anti-HLA-I antibodies. Antibody positivity status was associated with reduced graft function at 12 months and graft survival at 5 years (91.5% versus 96.4%,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.03<\/mml:mn><\/mml:math>). In multivariable Cox analysis, delayed graft function (HR\u2009=\u20096.1,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.01<\/mml:mn><\/mml:math>), HLA mismatches<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mrow><mml:mo>&gt;<\/mml:mo><\/mml:mrow><\/mml:math>3 (HR\u2009=\u200910.2,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.03<\/mml:mn><\/mml:math>), and antibody positivity for anti-HLA class II (HR\u2009=\u20095.1,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.04<\/mml:mn><\/mml:math>) or class I\/II (HR\u2009=\u200913.8,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\"><mml:mi>P<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.01<\/mml:mn><\/mml:math>) were independent predictors of graft loss.<jats:italic>Conclusions<\/jats:italic>. Allosensitization against HLA class<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\"><mml:mtext>I<\/mml:mtext><mml:mtext>I<\/mml:mtext><mml:mo>\u00b1<\/mml:mo><mml:mtext>I<\/mml:mtext><\/mml:math>after transplant was associated with adverse kidney graft outcomes. A screening protocol seems advisable within the first year in low immunological risk patients.<\/jats:p>","DOI":"10.1155\/2014\/438945","type":"journal-article","created":{"date-parts":[[2014,4,15]],"date-time":"2014-04-15T21:03:55Z","timestamp":1397595835000},"page":"1-8","source":"Crossref","is-referenced-by-count":5,"title":["Posttransplant Allosensitization in Low Immunological Risk Kidney and Kidney-Pancreas Graft Recipients"],"prefix":"10.1155","volume":"2014","author":[{"given":"Jorge","family":"Malheiro","sequence":"first","affiliation":[{"name":"Nephrology and Kidney Transplantation Department, Centro Hospitalar do Porto, Hospital de Santo Ant\u00f3nio, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal"}]},{"given":"Sandra","family":"Tafulo","sequence":"additional","affiliation":[{"name":"Centro do Sangue e Transplanta\u00e7\u00e3o do Porto, Rua de Bolama No. 133, 4200-139 Porto, Portugal"}]},{"given":"Leon\u00eddio","family":"Dias","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplantation Department, Centro Hospitalar do Porto, Hospital de Santo Ant\u00f3nio, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6110-2102","authenticated-orcid":true,"given":"La Salete","family":"Martins","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplantation Department, Centro Hospitalar do Porto, Hospital de Santo Ant\u00f3nio, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8984-1751","authenticated-orcid":true,"given":"Isabel","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplantation Department, Centro Hospitalar do Porto, Hospital de Santo Ant\u00f3nio, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal"}]},{"given":"Manuela","family":"Almeida","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplantation Department, Centro Hospitalar do Porto, Hospital de Santo Ant\u00f3nio, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8539-906X","authenticated-orcid":true,"given":"Sofia","family":"Pedroso","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplantation Department, Centro Hospitalar do Porto, Hospital de Santo Ant\u00f3nio, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal"}]},{"given":"F\u00e1tima","family":"Freitas","sequence":"additional","affiliation":[{"name":"Centro do Sangue e Transplanta\u00e7\u00e3o do Porto, Rua de Bolama No. 133, 4200-139 Porto, Portugal"}]},{"given":"Idalina","family":"Beir\u00e3o","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplantation Department, Centro Hospitalar do Porto, Hospital de Santo Ant\u00f3nio, Largo Prof. 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