The Presence of Pretransplant Antiphospholipid Antibodies IgA Anti-b-2-Glycoprotein I as a Predictor of Graft Thrombosis After Renal Transplantation
Identificadores
URI: http://hdl.handle.net/20.500.12020/1304ISSN: 0041-1337
DOI: https://doi.org/10.1097/TP.0000000000001199
Autor/es
Serrano, Manuel; Morales, Jose M; martinez-flores, jose angel; Perez, Dolores; Castro, Maria Jose; [et al.]Fecha
2017Tipo de documento
articleÁrea/s de conocimiento
Ciencias BiomédicasMateria/s Unesco
32 Ciencias MédicasResumen
Background. Vessel thrombosis is a severe complication after renal transplantation. Antibodies anti-β-2 glycoprotein-I of IgA
isotype (IgA-aB2GP1) have been linked to thrombotic events and mortality in hemodialysis patients. Methods. All kidney
transplanted patients from 2000 to 2011 (n = 1375) in our hospital were followed up for 2 years, evaluating 3 time periods.
Results. At transplantation, 401 patients were positive for IgA-aB2GPI (29.2%, group 1), and the remaining patients were
negative (group 2). Graft loss at 6 months posttransplantation was higher in group 1 (18% vs 7.2%; P < 0.001). The most
frequent cause of early graft loss was vessel thrombosis, especially in group 1 (12.2% vs 2.6% of patients; P < 0.001). In fact,
vessel thrombosis was the most important cause of graft loss in the 3 time periods, irrespective of demographic changes and
introduction of transplantation with asystolic donors. Notably, IgA-aB2GP1 was an independent risk factor for graft thrombosis
(odds ratio, 5.047; P < 0.001). Furthermore, the presence of IgA-aB2GP1 was associated with early graft loss and delayed
graft function. Mortality at 24 months was also higher in group 1. Conclusions. In conclusion, pretransplant IgA-aB2GP1
was the main risk factor for graft thrombosis and early graft loss. Further research should be made on whether anticoagulation in
antibody-positive patients could ameliorate this catastrophic complication