A study appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN) says that kidney transplant recipients who develop antibodies in response to receiving new organs can develop accelerated arteriosclerosis, or narrowing of the arteries that supply blood to the kidney.
The results indicate that arteriosclerosis resulting from such donor-specific antibodies may play an important role in organ rejection following transplantation.
Antibody-mediated transplant rejection-a process that occurs when a transplant recipient mounts antibodies against a new organ-can contribute to declining function and ultimately loss of transplanted kidneys. To study the effects of antibody-mediated transplant rejection, Gary Hill, MD (HĂ'pital EuropĂ©en Georges Pompidou, APHP, in Paris, France), Alexandre Loupy, MD, PhD (HĂ'pital Necker, APHP in Paris, France), and their colleagues examined kidney biopsies from 40 transplant patients who mounted antibodies directed against their transplanted kidney and 59 patients who did not.
The investigators found that narrowing of the arteries significantly progressed between three and 12 months after transplant in the antibody-positive patients but not in the antibody-negative patients. In those patients who did not develop antibodies, narrowing of the arteries progressed at approximately one third the rate of patients who did develop antibodies.
In the antibody-positive patients, narrowing of the arteries in the transplanted kidneys was much worse than expected based on the donor''s age and translated to approximately 28 years of "aging" in the first year after transplantation. "This accelerated arteriosclerosis can now be seen to form part of the rejection process, and it will probably be found to contribute to the ultimate decline of kidney function," said Dr. Hill.
The study''s results should spark considerable interest in the importance of arteriosclerosis following kidney transplantation. "Acceleration of arteriosclerosis was a totally unexpected finding, an important one since it broadens our thinking about what constitutes transplant rejection," said Dr. Hill.
Study co-authors (all in Paris, France) include Dominique Nochy, MD; Patrick Bruneval, MD; J. P. Duong van Huyen, MD, PhD (HĂ'pital EuropĂ©en Georges Pompidou, APHP and UniversitĂ© Paris Descartes); Denis Glotz, MD, PhD; Caroline Suberbielle, MD, PhD (HĂ'pital Saint Louis, APHP); Julien Zuber, MD, PhD; Dany Anglicheau, MD, PhD; Christophe Legendre, MD (UniversitĂ© Paris Descartes and HĂ'pital Necker, APHP); Jean-Philippe Empana, MD (INSERM, U970, Paris Cardiovascular Research Center-PAARC); and Alexandre Loupy, MD, PhD (UniversitĂ© Paris Descartes; HĂ'pital Necker, APHP; and INSERM, U970, Paris Cardiovascular Research Center-PAARC).
Disclosures: The authors reported no financial disclosures.
The article entitled, "Donor-Specific Antibodies Accelerate Arteriosclerosis after Kidney Transplantation," will appear online at http://jasn.asnjournals.org/
on April 14, 2011, doi 10.1681/ASN.2010070777.
The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.
Founded in 1966, and with more than 12,000 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.