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Moreira Jr Editora
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Summary

Introduction. Donor-specific antibodies (DSA) play a fundamental role in kidney transplant as a main barrier outcome and survival. Material and Methods. We evaluated a protocol in 100 patients receiving kidneys from deceased donors (DD). Recipients were classified as being at low risk (LR), medium (MR), high (HR) or strong (SR) of rejection based on Luminex PRA-Single Antigen Beads (SAB). Grafts that survived for one year were evaluated. Results. Of 100 recipients, 54(54%) were at LR, eight rejected, but four being with grafts lost, two by AMR, and one by non-immunological cause (NIC). Of 30(30%) at MR, 10(10%) had rejection episodes, of these four lost the grafts. Of them two lost by AMR (DSA MFI 530 and 870), one by CR and one by NIC. Of 10(10%) at HR, three had rejection episodes with three lost by AMR (DSA MFI 3493 to 6068). Of 6(6%) at SR, rejection episodes were observed in five recipients, of these four lost the grafts, three by AMR (DSA MFI 7226 to 12591), and one by CR. One-year graft survival for LR was 91.22%, 78,75% for MR, and 80.28%for HR+SH. Conclusion. This protocol based on fluxogram risk assessment of AMR provided fast and precise immunological evaluation and stratification of the recipients by immunological risk of AMR. Rejections were detected in 26(26%) patients of which 12(46%) patients lost the grafts by immunological causes, two by CR, and 10 patients by AMR. These finding can be ascribed the severity of the rejections. Furthermore, two patients lost the graft by NIC. 87(87%) patients maintained at good kidney function with sera Creatinine value of 0.9 to 1.6 mg/dL after one year graft survival.



Moreira JR Editora