Immunological Risk Monitoring in Patients with High Immunologic Risk and Its Effects on Clinical Outcomes

Abstract

Objective: In this study, it was aimed to follow up the immunological risk of patients with high immunological risk and to determine the effect of desensitization treatment in these patients. Materials and Methods: Living donor transplantation patients with panel reactive antibody (PRA), donor specific antibody (DSA), and/or single antigen bead test positivity and retransplantation patients were included in the study. PRA and/or DSA levels of pre-transplant and post-transplant period were evaluated in all patients. We compared follow-up of immunological data and clinical outcomes of patients who had desensitization (Group 1) versus who did not (Group 2). Results: Totally 117 patients were included in this study. Thirty-four patients had desensitization treatment. There was no statistically difference between the groups based on age, hepatitis serology, history of blood transfusion, pregnancy, history of dialysis, and acute rejection episodes (p>0.05). Female gender was higher in Group 1 patients (p<0.05). HLA-MM, PRA Class 2, DSA Class 2 levels were higher in Group 1 in pre-transplant period (p<0.05). During the follow-up period, it was determined that the patients in Group 1 had significantly lower PRA Class 2 values at the 1st month and DSA Class 2 values at the 1st and 3rd months compared to the pre-transplant period (p<0.05). Conclusion: Immunological risk decreases with desensitization therapy in the patients with high immunological risk. This decrease is more distinctive in the first 3 months of post-transplant period in which acute rejection attacks are more common.