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Table 2 Clinical characteristics of DSA-positive recipients

From: Clinical characteristics of renal transplant recipients who developed de novo donor-specific antigen in Kyoto University Hospital: a case series

Case no

Age

Sex

Primary disease

ABO

Delayed graft function

Time of DSA detection (post−Tx)

HLA

MFI

Reason for HLA screening

Biopsy

Treatment

Outcome

1

44

Male

IgA nephropathy

Compatible

With

275 months

DR13

DQ6

11226

19056

Protocol

cABMR

AZA→MMF

Alive with graft function

2

43

Male

Chronic glomerulonephritis

Compatible

Without

252 months

DQ6

20866

Serum Cr↑

cABMR+

CNI

Steroid pulse, PE, IVIG, Rit, mTOR

Alive with graft function

3

48

Male

Chronic glomerulonephritis

Compatible

Without

251 months

DR53

21566

Protocol

cABMR

AZA→MMF, steroid pulse

Alive with graft loss

4

61

Female

Unknown disease

Compatible

With

142 months

DR53

DQ4

DQ9

22850

21803

21530

Serum Cr↑

cABMR

Steroid pulse, PE, IVIG, Rit, mTOR

Alive with graft loss

5

54

Female

ADPKD

Compatible

Without

141 months

DQ7

7246

Protocol

Not definition for cABMR

Steroid pulse, PE, IVIG

Alive with graft function

6

53

Male

Sarcoidosis

Compatible

Without

88

months

DR53

3326

Protocol

nothing particular

Alive with graft function

7

44

Male

IgA nephropathy

Compatible

Without

52

months

DR51

15056

Serum Cr↑

Proteinuria↑

IgA+

cABMR

Steroid pulse, PE, IVIG, Rit

Alive with graft function

8

77

Male

IgA nephropathy

Compatible

Without

18

months

DQ7

14915

Serum Cr↑

Borderline change

rATG, steroid pulse, PE, IVIG

Alive with graft function

  1. ADPKD: Autosomal dominant polycystic kidney disease; DSA: donor-specific antigen; Tx: treatment; HLA: human leukocyte antigen; MFI: mean fluorescence intensity; Cr: creatinine; cABMR: chronic antibody-mediated rejection; CNI: calcineurin inhibitor; TCMR: T-cell-mediated rejection; AZA: azathioprine; MMF: mycophenolate mofetil; cABMR: chronic antibody-mediated rejection; DSA: donor-specific antigen; PE: plasma exchange; IVIG: intravenous immunoglobulin; Rit: rituximab; mTOR: mammalian target of rapamycin; rATG: rabbit antithymocyte globulin