Effect of Pre-Transplant Sensitization on Kidney Allograft Survival Following Simultaneous Liver and Kidney Transplantation: A Decade of Experience from an Academic Transplant Center.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος:	Effect of Pre-Transplant Sensitization on Kidney Allograft Survival Following Simultaneous Liver and Kidney Transplantation: A Decade of Experience from an Academic Transplant Center.
Συγγραφείς:	Santeusanio AD; Recanati-Miller Transplantation Institute, Mount Sinai Hospital, New York, New York, USA.; Department of Pharmacy, Mount Sinai Hospital, New York, New York, USA., Mahir F; Recanati-Miller Transplantation Institute, Mount Sinai Hospital, New York, New York, USA., Facciuto M; Icahn School of Medicine at Mount Sinai, New York, New York, USA., Shapiro R; Recanati-Miller Transplantation Institute, Mount Sinai Hospital, New York, New York, USA., Delaney V; Recanati-Miller Transplantation Institute, Mount Sinai Hospital, New York, New York, USA., Schiano T; Recanati-Miller Transplantation Institute, Mount Sinai Hospital, New York, New York, USA., Moon J; Recanati-Miller Transplantation Institute, Mount Sinai Hospital, New York, New York, USA., Florman S; Recanati-Miller Transplantation Institute, Mount Sinai Hospital, New York, New York, USA., Kim-Schluger L; Recanati-Miller Transplantation Institute, Mount Sinai Hospital, New York, New York, USA., Tedla F; Recanati-Miller Transplantation Institute, Mount Sinai Hospital, New York, New York, USA., Bhansali A; Recanati-Miller Transplantation Institute, Mount Sinai Hospital, New York, New York, USA.
Πηγή:	Clinical transplantation [Clin Transplant] 2026 Aug; Vol. 40 (8), pp. e70656.
Τύπος έκδοσης:	Journal Article
Γλώσσα:	English
Στοιχεία περιοδικού:	Publisher: Munksgaard Country of Publication: Denmark NLM ID: 8710240 Publication Model: Print Cited Medium: Internet ISSN: 1399-0012 (Electronic) Linking ISSN: 09020063 NLM ISO Abbreviation: Clin Transplant Subsets: MEDLINE
Imprint Name(s):	Original Publication: Copenhagen : Munksgaard
Ιατρικοί όροι (MeSH):	Kidney Transplantation/methods , Kidney Transplantation/mortality , Liver Transplantation/methods , Liver Transplantation/mortality , Histocompatibility Testing/methods , Histocompatibility Testing/statistics & numerical data , Graft Survival/immunology , Graft Rejection/immunology , Graft Rejection/mortality , Graft Rejection/prevention & control, Allografts/immunology ; Allografts/transplantation ; Kidney/immunology ; Preoperative Care/methods ; Preoperative Care/mortality ; Isoantibodies/blood ; Isoantibodies/immunology ; HLA Antigens/blood ; HLA Antigens/immunology ; Combined Modality Therapy ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; Follow-Up Studies ; Biopsy ; Humans ; Male ; Female ; Adult ; Middle Aged ; Aged
Περίληψη:	Background: There are conflicting data regarding the impact of pre-transplant sensitization on kidney allograft outcomes following simultaneous liver-kidney (SLK) transplantation. Methods: This was a single-center, retrospective study of adult SLK transplant recipients during the decade from 2010 to 2020. Patients were classified based on complement dependent cytotoxicity crossmatching (CDC-CXM) as well as the presence of donor specific antibodies (DSA) and followed until study conclusion on January 1, 2021. Cox-proportional hazards modeling was performed to identify clinical variables associated with combined patient and allograft survival as well as biopsy proven kidney rejection (BPAR). Results: A total of 90 patients were included in the study (16 positive CDC-CXM and 31 with DSA). Overall patient and allograft survival was 91.1% at 1-year and 68.9% at study conclusion after a median of 4.4 years, with corresponding death-censored kidney survival of 98.8% and 91.2%. In the multivariable analysis, a positive CDC-CXM (HR = 3.79; 95% CI 1.70-8.46) but not pre-formed DSA was associated with patient and graft loss. BPAR occurred in 12 patients (13.3%) and was higher among patients with DSA >5,000 (HR = 3.69; 95% CI 1.14-11.98), although this did not impact overall kidney survival. DSA cleared in 85% of patients following SLK transplant but persisted in three patients with DQ-specific antibodies. Conclusions: A positive CDC-CXM but not the presence of pre-formed DSA was associated with worse outcomes following SLK transplantation, with overall kidney survival primarily driven by death with a functioning allograft. DSA >5,000 MFI increased the risk for BPAR, and DSA to the class II DQ antigen were incompletely cleared following SLK transplant; however, overall kidney survival was not impacted. (© 2026 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
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Contributed Indexing:	Keywords: graft survival; kidney transplantation; liver transplantation; risk factors; sensitization
Substance Nomenclature:	0 (Isoantibodies) 0 (HLA Antigens)
Entry Date(s):	Date Created: 20260823 Date Completed: 20260831 Latest Revision: 20260831
Update Code:	20260901
PubMed Central ID:	PMC13500032
DOI:	10.1111/ctr.70656
PMID:	42633612
Βάση Δεδομένων:	MEDLINE

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ISSN:	1399-0012
DOI:	10.1111/ctr.70656