{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T20:07:37Z","timestamp":1786133257677,"version":"build-2736575974"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JASN"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:p>\n                    <jats:bold>Background<\/jats:bold>\n                    Complement-fixing antibodies against donor HLA are considered a contraindication for kidney transplant. A modification of the IgG single-antigen bead (SAB) assay allows detection of anti-HLA antibodies that bind C3d. Because early humoral graft rejection is considered to be complement mediated, this SAB-based technique may provide a valuable tool in the pretransplant risk stratification of kidney transplant recipients.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods<\/jats:bold>\n                    Previously, we established that pretransplant donor-specific anti-HLA antibodies (DSAs) are associated with increased risk for long-term graft failure in complement-dependent cytotoxicity crossmatch-negative transplants. In this study, we further characterized the DSA-positive serum samples using the C3d SAB assay.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    Among 567 pretransplant DSA-positive serum samples, 97 (17%) contained at least one C3d-fixing DSA, whereas 470 (83%) had non\u2013C3d-fixing DSA. At 10 years after transplant, patients with C3d-fixing antibodies had a death-censored, covariate-adjusted graft survival of 60%, whereas patients with non\u2013C3d-fixing DSA had a graft survival of 64% (hazard ratio, 1.02; 95% confidence interval, 0.70 to 1.48 for C3d-fixing DSA compared with non\u2013C3d-fixing DSA;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    =0.93). Patients without DSA had a 10-year graft survival of 78%.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions<\/jats:bold>\n                    The C3d-fixing ability of pretransplant DSA is not associated with increased risk for graft failure.\n                  <\/jats:p>","DOI":"10.1681\/asn.2018020205","type":"journal-article","created":{"date-parts":[[2018,7,26]],"date-time":"2018-07-26T09:25:41Z","timestamp":1532597141000},"page":"2279-2285","source":"Crossref","is-referenced-by-count":27,"title":["Pretransplant C3d-Fixing Donor-Specific Anti-HLA Antibodies Are Not Associated with Increased Risk for Kidney Graft Failure"],"prefix":"10.1681","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0252-5153","authenticated-orcid":false,"given":"Elena G.","family":"Kamburova","sequence":"first","affiliation":[{"name":"Laboratory of Translational Immunology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bram W.","family":"Wisse","sequence":"additional","affiliation":[{"name":"Laboratory of Translational Immunology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irma","family":"Joosten","sequence":"additional","affiliation":[{"name":"Laboratory Medicine, Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wil A.","family":"Allebes","sequence":"additional","affiliation":[{"name":"Laboratory Medicine, Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnold","family":"van der Meer","sequence":"additional","affiliation":[{"name":"Laboratory Medicine, Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luuk B.","family":"Hilbrands","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands; Departments of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marije C.","family":"Baas","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands; Departments of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Spierings","sequence":"additional","affiliation":[{"name":"Laboratory of Translational Immunology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelis E.","family":"Hack","sequence":"additional","affiliation":[{"name":"Laboratory of Translational Immunology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franka E.","family":"van Reekum","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjan D.","family":"van Zuilen","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne C.","family":"Verhaar","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel L.","family":"Bots","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriaan C.A.D.","family":"Drop","sequence":"additional","affiliation":[{"name":"Laboratory of Translational Immunology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loes","family":"Plaisier","sequence":"additional","affiliation":[{"name":"Laboratory of Translational Immunology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc A.J.","family":"Seelen","sequence":"additional","affiliation":[{"name":"Nephrology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Stephan","family":"Sanders","sequence":"additional","affiliation":[{"name":"Nephrology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bouke G.","family":"Hepkema","sequence":"additional","affiliation":[{"name":"Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annechien J.A.","family":"Lambeck","sequence":"additional","affiliation":[{"name":"Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura B.","family":"Bungener","sequence":"additional","affiliation":[{"name":"Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Roozendaal","sequence":"additional","affiliation":[{"name":"Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel G.J.","family":"Tilanus","sequence":"additional","affiliation":[{"name":"Department of Transplantation Immunology, Tissue Typing Laboratory and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina E.","family":"Voorter","sequence":"additional","affiliation":[{"name":"Department of Transplantation Immunology, Tissue Typing Laboratory and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lotte","family":"Wieten","sequence":"additional","affiliation":[{"name":"Department of Transplantation Immunology, Tissue Typing Laboratory and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elly M.","family":"van Duijnhoven","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari\u00eblle A.C.J.","family":"Gelens","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten H.L.","family":"Christiaans","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frans J.","family":"van Ittersum","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Amsterdam Cardiovascular Sciences, Vrije Universiteit Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaikh A.","family":"Nurmohamed","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Amsterdam Cardiovascular Sciences, Vrije Universiteit Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neubury M.","family":"Lardy","sequence":"additional","affiliation":[{"name":"Department of Immunogenetics, Sanquin, Amsterdam, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Swelsen","sequence":"additional","affiliation":[{"name":"Department of Immunogenetics, Sanquin, Amsterdam, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karlijn A.M.I.","family":"van der Pant","sequence":"additional","affiliation":[{"name":"Renal Transplant Unit, Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neelke C.","family":"van der Weerd","sequence":"additional","affiliation":[{"name":"Renal Transplant Unit, Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ineke J.M.","family":"ten Berge","sequence":"additional","affiliation":[{"name":"Renal Transplant Unit, Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederike J.","family":"Bemelman","sequence":"additional","affiliation":[{"name":"Renal Transplant Unit, 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