Transplant immunology最新文献

{"title":"Natural killer cell KIR genotype and NKG2C phenotype in correlation to BKV infection following kidney transplantation","authors":"Shubo Tan ,&nbsp;Xiaobin Lin ,&nbsp;Xueqi Li,&nbsp;Jianhua Long,&nbsp;Yuan Luo,&nbsp;Yao Xiao,&nbsp;Jianjun Li","doi":"10.1016/j.trim.2025.102303","DOIUrl":"10.1016/j.trim.2025.102303","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the correlation between the NK cell killer immunoglobulin-like receptor (KIR) genotype, NKG2C phenotype, and BK virus (BKV) infection following kidney transplantation.</div></div><div><h3>Methods</h3><div>Clinical data from 51 recipients who underwent allogeneic kidney transplantation were retrospectively analyzed. Recipients were grouped based on their KIR genotype (A/A or B/X genotype) and NKG2C⁺ NK cell ROC cut-off values. SPSS statistical analysis software was used to assess their association with BKV infection.</div></div><div><h3>Results</h3><div>Seventeen recipients with the KIR-A/A genotype and 34 with the KIR-B/X genotype were included in this study. Statistical analysis revealed a significant difference in the distribution of activating KIR gene numbers between the two groups. Univariate analysis revealed significant differences in survival curves between the groups according to KIR genotype and activating KIR gene number. Cox multivariate analysis identified the KIR genotype and delayed graft function as independent factors influencing BKV infection following kidney transplantation. ROC curve analysis revealed that the area under the curve for the NKG2C⁺ NK cell ratio in the infection-free survival (IFS) evaluation was 0.788, with an optimal cutoff value of 16.5 %. BKV infection rates in recipients with NKG2C⁺ NK cell ratios &lt;16.5 % and ≥ 16.5 % were 66.7 % and 20 %, respectively. Recipients with NKG2C⁺ NK cell ratios &lt;16.5 % had worse IFS than those with NKG2C⁺ NK cell ratios ≥16.5 %.</div></div><div><h3>Conclusion</h3><div>A correlation was found between NK cell KIR genotype, NKG2C⁺ NK cell phenotype, and BKV infection following kidney transplantation, providing a reference for selecting suitable donors for transplantation and reducing the risk of post-transplant BKV infection.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102303"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hematopoietic stem cell transplantation across ABO compatibility barrier in HLA genoidentical related donor: Is it an unfavorable factor for overall survival (OS) in Tunisian patients?","authors":"Mohamed Hichem Sellami ,&nbsp;Yesmine Boughzala ,&nbsp;Eya Ghazouani ,&nbsp;Nour Ben Abdeljelil ,&nbsp;Ines Turki ,&nbsp;Wafa Aissa ,&nbsp;Manel Chaabane ,&nbsp;Houda Kaabi ,&nbsp;Tarek Ben Othman ,&nbsp;Slama Hmida","doi":"10.1016/j.trim.2025.102311","DOIUrl":"10.1016/j.trim.2025.102311","url":null,"abstract":"<div><div>Benchmarking of survival following Hematopoietic Stem Cell Transplantation (HSCT) is very useful in the field of transplant medicine. It has been reported that decreased survival rates after HSCT may be affected by the ABO mismatch in some cases. In this study, we aim to assess this relationship in a Tunisian cohort of adult patients who have received HSCT from HLA genoidentical related donors.</div><div>A total of 147 patients and their 147 respective related donors, were retrospectively analyzed in this study. HLA and ABO antigens typing was performed according to established routine methods. Overall Survival (OS) was measured from the date of the HSCT until death from any cause or the last follow-up examination. OS in the ABO-matched group and the ABO-mismatched groups was accessed using mean survival time, comparison of survival curves (using the Logrank test) and calculation of the hazard ratios (HR) with 95 % confidence interval (CI).</div><div>The comparison of survival curves showed no significant difference (chi2 = 0.898, <em>p</em> = 0.825) in the OS between the ABO-compatible graft recipients and those who are incompatible (Bidirectional, Major or Minor incompatibility). Survival analysis with HR showed no difference in mortality between the fourth targeted subgroups. This is the same result even when the source of the hematopoietic graft, i.e., peripheral blood stem cells (PBSCs) or bone marrow (BM) stem cells, was taken into consideration.</div><div>It is very likely that there is no effect of ABO mismatching on OS in Tunisian adult recipients of HSCs. This result is in good agreement with that of other recent reports that failed to establish a significant relationship between ABO incompatibility and OS after the HSCT.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102311"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent sarcoidosis in a transplanted kidney: A case report and literature review","authors":"Abd Assalam Qannus ,&nbsp;H. Tahsin Özpolat ,&nbsp;Dory Salazar ,&nbsp;Erica Bracamonte ,&nbsp;Bekir Tanriover ,&nbsp;Venkatesh Ariyamathu","doi":"10.1016/j.trim.2025.102300","DOIUrl":"10.1016/j.trim.2025.102300","url":null,"abstract":"<div><div>Sarcoidosis is a multisystem inflammatory disorder that primarily affects the lungs. However, extra-pulmonary involvement, including the kidneys and heart, is also observed. Kidney involvement may manifest as hypercalcemia or as acute or chronic kidney injury, which could progress to end-stage kidney disease. Patients with sarcoidosis have been reported to successfully undergo kidney transplants, although some have experienced recurrence of sarcoidosis after the transplant, affecting both the kidneys and other organs. Here, we present a case of a patient who underwent a kidney transplant followed by the recurrence of sarcoidosis, which manifested as hypercalcemia five months after the transplant.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102300"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of dd-cfDNA and CXCL-10 in kidney allograft recipients for identifying acute rejection","authors":"Qi Yu ,&nbsp;Yan Zhang ,&nbsp;Zijian Gao ,&nbsp;Boqian Wang ,&nbsp;Hongwei Yang ,&nbsp;Long He","doi":"10.1016/j.trim.2025.102307","DOIUrl":"10.1016/j.trim.2025.102307","url":null,"abstract":"<div><h3>Background and hypothesis</h3><div>Acute rejection (AR) remains a major challenge in kidney transplantation. Current methods used to diagnose acute rejection are either invasive or not sufficiently sensitive. Thus, in this study, we aimed to develop a novel and sensitive diagnostic tool for predicting acute rejection after kidney transplantation. We investigated if donor-derived cell-free DNA (dd-cfDNA) in the serum and C-X-C motif chemokine 10 (CXCL-10) levels were closely related to the occurrence of AR after renal transplantation.</div></div><div><h3>Methods</h3><div>We collected data and tested the serum levels of dd-cfDNA and CXCL-10 in AR patients and patients who underwent kidney transplantation during the same period. Logistic analysis was used to verify risk factors associated with AR. The analysis of the receiver operating characteristic curve(ROC) was used to reveal correlation between dd-cfDNA，CXCL-10 levels and AR patients.</div></div><div><h3>Results</h3><div>We included 13 AR patients and 18 patients without acute rejection. The AR group had a lower BMI (<em>P</em> = 0.006), and higher levels of eGFR (<em>P</em> = 0.006) and CysC (<em>P</em> = 0.009). Additionally, ln dd-cfDNA percentage and ln CXCL-10 content were higher in the AR group compared to the control group (<em>P</em> = 0.007, <em>P</em> = 0.004).The results of logistic analysis suggested CysC(OR:2.562[95 % CI:1.377–4.766]，<em>P</em> = 0.003),ln dd-cfDNA percent (OR: 10.521 [95 % CI: 2.091–52.938]，<em>P</em> = 0.004), and ln CXCL-10 content(OR:49.052 [95 % CI: 1.730–1391.073]，<em>P</em> = 0.023) can indicate the risk of AR and were independently correlated with the occurrence of acute rejection of the kidney graft. The AUC of serum dd-cfDNA (AUC = 0.723, <em>P</em> = 0.0348) percent and CXCL-10 content (AUC = 0.814, <em>P</em> = 0.0029) showed significant diagnostic performance. The combined dd-cfDNA and CXCL-10 diagnosis showed higher AUC and specificity.</div></div><div><h3>Conclusions</h3><div>Serum dd-cfDNA and CXCL-10 levels were significantly elevated in patients with acute rejection. Thus, dd-cfDNA and CXCL-10 can play suggestive roles in detecting graft injury after kidney transplantation.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102307"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the influence of isolation techniques on NK cell transcriptomic profiles","authors":"Rana ElNouty ,&nbsp;Ahmed Moustafa ,&nbsp;Maha Mostafa ,&nbsp;Amged Ouf ,&nbsp;Khaled Abou-Aisha ,&nbsp;Mona Rady","doi":"10.1016/j.trim.2025.102298","DOIUrl":"10.1016/j.trim.2025.102298","url":null,"abstract":"<div><div>Natural Killer (NK) cells are vital components of the innate immune system, playing a crucial role in defending the body against tumors and virally infected cells. While various methods exist for their isolation, the profound impact of these techniques on NK cell biology remains poorly characterized.This study presents a comprehensive analysis of the transcriptomic profiles of NK cells isolated using different positive selection methods; anti-CD56, anti-CD7 (with two distinct lineage depletion protocols), and a combination of anti-CD16 and anti-CD56 antibodies, compared to negative selection using immunomagnetic beads. Our integrated analysis of RNA-Seq datasets revealed that the isolation method is a dominant source of transcriptomic variation, accounting for 68.6 % of the total dataset variance, with technical factors being inextricably confounded with this biological signal. We identified extensive method-specific transcriptional signatures, with minimal overlap (&lt;0.1 %) in differentially expressed genes (DEGs) across techniques. Functional enrichment analysis demonstrated that these signatures correspond to starkly different functional states: anti-CD16/anti-CD56 selection enriched for a highly activated, cytotoxically competent NK cell population with upregulated pathways in cytotoxicity and immune surveillance, while one anti-CD7-based method captured NK cells in a suppressed state, showing significant downregulation of lymphocyte activation and cytotoxicity pathways. Marker expression analysis further revealed extreme inter-study heterogeneity, with fold-changes in key cytotoxic genes exceeding 70,000-fold between methods. These findings highlight that the choice of isolation technique is not neutral but fundamentally determines the transcriptional and functional identity of the studied NK cell population. Our results highlight the critical importance of methodological standardization in NK cell research and provide essential guidance for selecting isolation strategies tailored to specific research or therapeutic applications.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102298"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fxyd5 downregulation protects the heart from ischemia/reperfusion injury by suppressing myocardial inflammation","authors":"Lei Zhang ,&nbsp;Junjie Xu ,&nbsp;Fujiang Cui ,&nbsp;Jin Jin ,&nbsp;Liwen Liu ,&nbsp;Lei Wang ,&nbsp;Yuxia Gao","doi":"10.1016/j.trim.2025.102282","DOIUrl":"10.1016/j.trim.2025.102282","url":null,"abstract":"<div><h3>Background</h3><div>Myocardial ischemia/reperfusion (I/R) injury is a common cause of death. FXYD domain-containing ion transport regulator-5 (Fxyd5) is a type I membrane protein that plays a significant role in mediating cellular functions. However, the expression and function of Fxyd5 in myocardial I/R injury remain unclear.</div></div><div><h3>Methods</h3><div>Male C57BL/6 mice (8–10 weeks) were subjected to myocardial I/R by ligating the left anterior descending coronary artery. Preventive intervention was performed using adeno-associated virus 9 (AAV9)-mediated Fxyd5 knockdown. An in vitro hypoxia/reoxygenation (H/R) in H9c2 cardiomyoblasts was used for validation.</div></div><div><h3>Results</h3><div>Myocardial I/R injury significantly upregulated Fxyd5 expression (<em>p</em> &lt; 0.01). Silencing Fxyd5 markedly improved cardiac function, as evidenced by a 58.0 % increase in EF (<em>p</em> &lt; 0.01) and a 54.5 % reduction in infarct size (<em>p</em> &lt; 0.01). Fxyd5 knockdown also attenuated myocardial apoptosis and inflammation, demonstrated by decreased cleaved caspase-3 expression and reduced levels of IL-6 (−44.2 %) and TNF-α (−42.7 %) (<em>p</em> &lt; 0.01). Mechanistically, Fxyd5 silencing suppressed NF-κB activation, and these protective effects were confirmed in vitro in H/R-treated cardiomyocytes.</div></div><div><h3>Conclusion</h3><div>Fxyd5 silencing significantly attenuated I/R-induced myocardial injury, reduced infarct size, and improved cardiac function, while also decreasing apoptosis and inflammatory cytokine expression (<em>p</em> &lt; 0.01). These findings indicate that Fxyd5 contributes to the pathogenesis of myocardial I/R injury and that its inhibition confers cardioprotective effects, partly through suppression of the NF-κB pathway.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102282"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pronase treatment enhances the sensitivity of B cell flow cytometry crossmatch: A single-center data analysis","authors":"Yan Li ,&nbsp;Dean Sylvaria ,&nbsp;Madeleine Billingsley ,&nbsp;Indira Guleria","doi":"10.1016/j.trim.2025.102325","DOIUrl":"10.1016/j.trim.2025.102325","url":null,"abstract":"<div><div>The Flow Cytometry Crossmatch (FCXM) is a vital tool in HLA laboratories for assessing transplantation immunological risk. This study evaluates FCXM results using data from 2018 to 2023, with the aim to assess the efficacy of pronase treatment in FCXM assay by comparing control serum samples in the FCXM assays performed during this time period. Tests followed our standard protocol using the BD FACSLyric™ Flow Cytometry System and BD FACSCalibur™ Flow Cytometry System, employing normal human serum (NHS) as negative control and pooled patient serum samples with strong anti-HLA antibodies as positive control. Pronase and non-pronase tests were performed and compared to rule out any false T cell positive crossmatches that could be attributable to pronase treatment.</div><div>Results showed no significant difference in delta values for T cell crossmatches between pronase-treated (MCS 256 ± 112) and non-treated (MCS 247 ± 116) groups (<em>p</em> = 0.253). However, B cell crossmatches had significantly higher delta values with pronase treatment (MCS 353 ± 129) versus non-treatment (MCS 300 ± 117), indicating enhanced sensitivity with pronase (<em>p</em> &lt; 0.000001). Pronase-treated B cell negative controls had lower signal (MCS 245 ± 61) compared to non-treated (MCS 300 ± 73), with positive control values consistent across both groups.</div><div>Anti-CD23 analysis demonstrated a reduction in all the tests performed (MCS 372 ± 64 vs 217 ± 50), confirming efficacy of pronase treatment. These findings highlight the importance of pronase in improving FCXM sensitivity for B cells, enhancing the accuracy and reliability of FCXM protocols for better transplantation outcomes.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102325"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral cyclosporine a nanosuspension for improved immunosuppressive efficacy: In vivo cytokine profiling in rats","authors":"Çağman Tan ,&nbsp;Sıla Gülbağ Pınar ,&nbsp;Nevin Çelebi","doi":"10.1016/j.trim.2025.102301","DOIUrl":"10.1016/j.trim.2025.102301","url":null,"abstract":"<div><h3>Background</h3><div>Cyclosporine A (CycA) is a cornerstone immunosuppressant in transplantation, but its poor solubility and variable bioavailability limit therapeutic efficacy. Nanosuspension technology offers an innovative formulation strategy to enhance oral absorption and potentially improve immunomodulatory effects.</div></div><div><h3>Methods</h3><div>Wistar rats (<em>n</em> = 4/group) received oral CycA as coarse powder, physical mixture, commercial product, or nanosuspension. Serum cytokines and chemokines (IL-4, IL-5, IL-10, IL-13, IL-17 A, Eotaxin, GRO-α, IP-10, MCP-1, MCP-3, MIP-1α, MIP-2, Rantes) were quantified on days 7, 14, and 21. Data were expressed as mean ± SD. Statistical analysis was performed using Mann–Whitney <em>U</em> test with Benjamini–Hochberg correction for multiple comparisons.</div></div><div><h3>Results</h3><div>At day 21, IL-10 levels were significantly higher in the nanosuspension group compared to control and coarse powder (adjusted <em>p</em> = 0.041), confirming nanosuspension-mediated IL-10 upregulation. IL-13 was also elevated in nanosuspension and commercial product groups versus control (p_adj = 0.048). IL-4 was significantly reduced in the nanosuspension group at both day 7 (p_adj = 0.042) and day 21 (p_adj = 0.049). IL-5 levels increased in the nanosuspension group at day 21 compared to control and coarse powder (p_adj = 0.037). No statistically significant differences were detected for IL-17 A or chemokines, although descriptive trends suggested altered profiles in the nanosuspension group.</div></div><div><h3>Conclusion</h3><div>CycA nanosuspension selectively modulates cytokine networks by elevating IL-10, fine-tuning Th2 cytokines (IL-4, IL-5, IL-13), and trending toward chemokine regulation. These findings highlight nanosuspension technology as a promising strategy to enhance CycA's immunosuppressive efficacy, with potential implications for transplantation.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102301"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of intravenous immunoglobulin (IVIG) treatment on BK viremia and BK virus-associated nephropathy (BKVN) in kidney transplant patients: A systematic review","authors":"Maryam Hassanian ,&nbsp;Mojgan Mortazavi ,&nbsp;Firouzeh Moeinzadeh","doi":"10.1016/j.trim.2025.102288","DOIUrl":"10.1016/j.trim.2025.102288","url":null,"abstract":"<div><h3>Background</h3><div>There are limited approved therapeutic options for BK viremia management in kidney transplant patients. We performed the present study to investigate the effect of Intravenous immunoglobulin (IVIG) treatment on BK viremia and BK virus-associated nephropathy (BKVN) in kidney transplant patients.</div></div><div><h3>Methods</h3><div>A systematic search was performed in Web of Science, Embase, PubMed, and Scopus for studies that investigated the effect of IVIG therapy on BK viremia and BKVN in kidney transplant patients. Observational studies and case series were considered eligible for inclusion in this study. Data extraction was performed by two independent investigators by a standard checklist.</div></div><div><h3>Findings</h3><div>Our results indicated that IVIG treatment in patients with BKVN was effective in BK viremia treatment and nephropathy. In addition, preemptive IVIG significantly decreased the risk of BK viremia and BKVN in high-risk patients. However, it does not seem that IVIG treatment has a beneficial impact on allograft function. Because no significant improvement in serum levels of creatinine has been reported in previous studies. In addition, the presence of interstitial fibrosis or tubular atrophy was reported in studies with histopathological examinations of renal biopsies following IVIG treatment.</div></div><div><h3>Conclusion</h3><div>IVIG therapy combined with immunosuppression reduction may be beneficial in treating BK viremia and BKVN, but its impact on graft function and survival remains uncertain. Further studies are needed to clarify its role in kidney transplant outcomes.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102288"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"De novo donor specific antibody (dnDSA) development with tacrolimus versus Belatacept based regimens in kidney transplant recipients","authors":"Cayla Kass ,&nbsp;Goni Katz-Greenberg ,&nbsp;Jason Bodner ,&nbsp;Scott Sanoff ,&nbsp;Alice Parish ,&nbsp;Alaattin Erkanli ,&nbsp;Jennifer Byrns","doi":"10.1016/j.trim.2025.102297","DOIUrl":"10.1016/j.trim.2025.102297","url":null,"abstract":"<div><h3>Purpose</h3><div>Belatacept has been associated with less de novo specific antibody (dnDSA) development, but few publications have compared the incidence of dnDSA development between tacrolimus and belatacept-based immunosuppression regimens. The purpose of this study was to investigate the differences in dnDSA development and clinical outcomes between these two maintenance regimens in kidney transplant.</div></div><div><h3>Methods</h3><div>This was a retrospective, single center, cohort study of patients transplanted between 2013 and 2019 who received a de novo belatacept or tacrolimus-based immunosuppression regimen. The primary outcome was the incidence of dnDSA development (MFI ≥ 1000) at 36 months. Secondary outcomes included renal function, biopsy proven rejection (BPAR), and patient/graft survival.</div></div><div><h3>Results</h3><div>Ninety patients met inclusion criteria. The primary outcome occurred in 4 (8.9 %) belatacept patients and 6 (13.3 %) tacrolimus patients, with an overall median time to dnDSA of 300 days (<em>p</em> = 0.51). Class II dnDSA development occurred in 3 (6.7 %) belatacept patients and 6 (13.3 %) tacrolimus patients. Belatacept patients had a lower, but not significantly different, rate of developing BPAR (4.4 % vs 13.3 %, <em>p</em> = 0.13) and had superior renal function at 36 months (median 66 ml/min vs 53 ml/min, <em>p</em> &lt; 0.01). Overall, there was excellent patient/graft survival at 36 months post-transplant.</div></div><div><h3>Conclusion</h3><div>De novo belatacept use did not result in a statistically significant difference in the development of dnDSAs but did show a numerically lower class II dnDSA and BPAR development. Overall, belatacept was associated with improved renal function as compared to tacrolimus-based regimens.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102297"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}