15 November 2013 : Original article
Humoral immunity after kidney transplantation: Impact of two randomized immunosuppressive protocols
Tristan LegrisABCDEF, Christophe PicardBDEF, Valérie MoalABE, Stéphane BurteyDE, Anderson LoundouC, Raj PurgusBDE, Bertrand DussolADE, Yvon BerlandADE, Henri Vacher-CoponatABCDEFGDOI: 10.12659/AOT.889536
Ann Transplant 2013; 18:622-634
Abstract
BACKGROUND: Controlling alloimmune humoral response is a challenge in transplantation. Few studies have evaluated the impact of maintenance immunosuppression on blood humoral parameters.
MATERIAL AND METHODS: We performed a post-hoc analysis on 307 kidney transplant recipients included in a prospective randomized trial comparing tacrolimus/mycophenolate mofetil (Tac/MMF) vs. cyclosporine/azathioprine (CsA/AZA), both used with antithymocyte globulin induction and steroids. Humoral parameters were analyzed at D0, D15, and M12.
RESULTS: IgG, IgA, and IgM levels decreased significantly as soon as D15 in both groups (–35%, –26%, and –35% respectively, vs. D0). At M12, although peripheral B-cell counts did not differ between the groups, Tac/MMF regimen was associated with lower IgG, IgA, and IgM levels than CsA/AZA (–5.9%, –14.6%, and –34%, respectively). Hypogammaglobulinemia at D15 was not associated with an increased risk of infections during the first year. The proportion of HLA-sensitized patients decreased in the Tac/MMF group (15.9% at D0 and 6.7% at M12, p=0.02) and remained stable in the CsA/AZA group (10.3% at D0 and 8.9% at M12, p=0.5). More patients sensitized at baseline became non-sensitized at M12 with Tac/MMF than with CsA/AZA.
CONCLUSIONS: Our results suggest humoral immunosuppression is better with Tac/MMF than with CsA/AZA during the first year of kidney transplantation.
Keywords: Tacrolimus, Mycophenolate Mofetil, HLA antibodies, azathioprine, Cyclosporine A, Immunoglobulins
In Press
Original article
Post-Liver Transplantation Atrial Fibrillation: Insights into Clinical and ECG PredictorsAnn Transplant In Press; DOI: 10.12659/AOT.948243
Original article
Prognostic Nutritional Index Trajectories Predict Kidney Function in Kidney Transplant Recipients: A Latent...Ann Transplant In Press; DOI: 10.12659/AOT.947388
Most Viewed Current Articles
03 Jan 2023 : Original article 6,942
Impact of Autologous Stem Cell Transplantation on Primary Central Nervous System Lymphoma in First-Line and...DOI :10.12659/AOT.938467
Ann Transplant 2023; 28:e938467
15 Aug 2023 : Review article 6,909
Free-Circulating Nucleic Acids as Biomarkers in Patients After Solid Organ TransplantationDOI :10.12659/AOT.939750
Ann Transplant 2023; 28:e939750
16 May 2023 : Original article 6,682
Breaking Antimicrobial Resistance: High-Dose Amoxicillin with Clavulanic Acid for Urinary Tract Infections ...DOI :10.12659/AOT.939258
Ann Transplant 2023; 28:e939258
28 May 2024 : Original article 6,102
Effect of Dexmedetomidine Combined with Remifentanil on Emergence Agitation During Awakening from Sevoflura...DOI :10.12659/AOT.943281
Ann Transplant 2024; 29:e943281