Next Article in Journal
Progesterone-Calcitriol Combination Enhanced Cytotoxicity of Cisplatin in Ovarian and Endometrial Cancer Cells In Vitro
Previous Article in Journal
Current Advances in Pediatric Onset Multiple Sclerosis
Open AccessArticle

Immunosuppression with Calcineurin Inhibitor after Renal Transplant Failure Inhibits Allosensitization

1
Nephrology Department, University Hospital Marqués de Valdecilla-IDIVAL, 39008 Santander, Spain
2
Immunology Department, University Hospital Marqués de Valdecilla-IDIVAL, 39008 Santander, Spain
3
Hematology Department, University Hospital Marqués de Valdecilla-IDIVAL, 39008 Santander, Spain
*
Author to whom correspondence should be addressed.
Biomedicines 2020, 8(4), 72; https://doi.org/10.3390/biomedicines8040072
Received: 14 February 2020 / Revised: 16 March 2020 / Accepted: 26 March 2020 / Published: 28 March 2020
(This article belongs to the Section Therapeutic Strategies in Different Diseases)
Immunosuppression withdrawal after graft failure seems to favor sensitization. A high percentage of calculated panel-reactive antibody (cPRA) and the development of de novo donor specific antibodies (dnDSA) indicate human leukocyte antigen (HLA) sensitization and may hinder the option of retransplantation. There are no established protocols on the immunosuppressive treatment that should be maintained after transplant failure. A retrospective analysis including 77 patients who lost their first renal graft between 1 January 2006–31 December 2015 was performed. Two sera were selected per patient, one immediately prior to graft loss and another one after graft failure. cPRA was calculated by Single Antigen in all patients. It was possible to analyze the development of dnDSA in 73 patients. By multivariate logistic regression analysis, the absence of calcineurin inhibitor (CNI) at 6 months after graft failure was related to cPRA > 75% (OR 4.8, CI 95% 1.5–15.0, p = 0.006). The absence of calcineurin inhibitor (CNI) at 6 months after graft loss was significantly associated with dnDSA development (OR 23.2, CI 95% 5.3–100.6, p < 0.001). Our results suggest that the absence of CNI at the sixth month after graft loss is a risk factor for sensitization. Therefore, maintenance of an immunosuppressive regimen based on CNI after transplant failure should be considered when a new transplant is planned, since it seems to prevent HLA allosensitization. View Full-Text
Keywords: allosensitization; donor-specific antibody; calcineurin inhibitor; graft nephrectomy allosensitization; donor-specific antibody; calcineurin inhibitor; graft nephrectomy
Show Figures

Graphical abstract

MDPI and ACS Style

López del Moral Cuesta, C.; Guiral Foz, S.; Gómez Pereda, D.; Pérez Canga, J.L.; de Cos Gómez, M.; Mazón Ruiz, J.; García Santiago, A.; Romón Alonso, J.I.; Valero San Cecilio, R.; Rodrigo Calabia, E.; San Segundo Arribas, D.; López Hoyos, M.; Ruiz San Millán, J.C. Immunosuppression with Calcineurin Inhibitor after Renal Transplant Failure Inhibits Allosensitization. Biomedicines 2020, 8, 72.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Search more from Scilit
 
Search
Back to TopTop