Antibodies against ARHGDIB are associated with long-term kidney graft loss

  • Elena G Kamburova
  • , Maartje L Gruijters
  • , Tineke Kardol-Hoefnagel
  • , Bram W Wisse
  • , Irma Joosten
  • , Wil A Allebes
  • , Arnold van der Meer
  • , Luuk B Hilbrands
  • , Marije C Baas
  • , Eric Spierings
  • , Cornelis E Hack
  • , Franka E van Reekum
  • , Arjan D van Zuilen
  • , Marianne C Verhaar
  • , Michiel L Bots
  • , Adriaan C A D Drop
  • , Loes Plaisier
  • , Rowena C A Melchers
  • , Marc A J Seelen
  • , Jan Stephan Sanders
  • Bouke G Hepkema, Annechien J A Lambeck, Laura B Bungener, Caroline Roozendaal, Marcel G J Tilanus, Christina E Voorter, Lotte Wieten, Elly M van Duijnhoven, Mariëlle A C J Gelens, Maarten H L Christiaans, Frans J van Ittersum, Shaikh A Nurmohamed, Neubury M Lardy, Wendy Swelsen, Karlijn A M I van der Pant, Neelke C van der Weerd, Ineke J M Ten Berge, Andries Hoitsma, Paul J M van der Boog, Johan W de Fijter, Michiel G H Betjes, Sebastiaan Heidt, Dave L Roelen, Frans H Claas, Frederike J Bemelman, Henny G Otten

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Abstract

The clinical significance of non-HLA antibodies on renal allograft survival is a matter of debate, due to differences in reported results and lack of large-scale studies incorporating analysis of multiple non-HLA antibodies simultaneously. We developed a multiplex non-HLA antibody assay against 14 proteins highly expressed in the kidney. In this study, the presence of pretransplant non-HLA antibodies was correlated to renal allograft survival in a nationwide cohort of 4770 recipients transplanted between 1995 and 2006. Autoantibodies against Rho GDP-dissociation inhibitor 2 (ARHGDIB) were significantly associated with graft loss in recipients transplanted with a deceased-donor kidney (N = 3276) but not in recipients of a living-donor kidney (N = 1496). At 10 years after deceased-donor transplantation, recipients with anti-ARHGDIB antibodies (94/3276 = 2.9%) had a 13% lower death-censored covariate-adjusted graft survival compared to the anti-ARHGDIB-negative (3182/3276 = 97.1%) population (hazard ratio 1.82; 95% confidence interval, 1.32-2.53; P =.0003). These antibodies occur independently from donor-specific anti-HLA antibodies (DSA) or other non-HLA antibodies investigated. No significant relations with graft loss were found for the other 13 non-HLA antibodies. We suggest that pretransplant risk assessment can be improved by measuring anti-ARHGDIB antibodies in all patients awaiting deceased-donor transplantation.

Original languageEnglish
Pages (from-to)3335-3344
Number of pages10
JournalAmerican Journal of Transplantation
Volume19
Issue number12
Early online date13 Jun 2019
DOIs
Publication statusPublished - Dec 2019

Keywords

  • ARHGDIB
  • kidney transplantation
  • non-HLA antibodies

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