POS-765 Relationship between presence of anti-HLA antibodies, kidney function and degree of pathological damage in patients with kidney transplant.

Abstract

Kidney transplantation is the first line treatment for patients with end-stage kidney disease. The presence of Donor Specific Antibodies (DSA) in Human Leukocyte Antigen (HLA) is considered a risk factor for graft loss. Biopsy histological damage, renal function and complications within a year of kidney transplantation with and without HLA antibodies, was evaluated. Retrospective, longitudinal, analytical study. All kidney transplant recipients 18 years and older, transplanted 2015-2017, with DSA determination and graft biopsy in the first year of transplantation, were included. One hundred twenty four patients were included. Average age was 48 +/- 14 years. The distribution by sex was higher for males 62%, 52 were living donors and 72 deceased donors. GROUP A: 44% of all patients had antibodies, of which 56% had anti-HLA Class I antibodies and 44% anti-HLA Class II antibodies. GROUP B: Negative antibodies patients (56%). In both groups, the three most frequent pathological results were Interstitial Fibrosis and Tubular Atrophy Grade I (Group A: 62% -Group B: 46%), followed by Chronic Graft Glomerulopathy Grade I / Interstitial Fibrosis and Tubular Atrophy Grade I (Group A: 10% -Group B: 12%) and Mild mesangial expansion (Group A: 8% -Group B: 7%). There was no significant difference between both groups. Mean creatininemia in both groups was 1.4 mg / dl (p = 0.54). In group A, 62.3% of the patients had complications and in group B 56.3% (OR 1.28 CI 0.6-2.6 p 0.58). The most prevalent transplant complication was urinary tract infections (Group A 22% - Group B 18%) in both groups, no significant difference. In absence of rejection, HLA antibodies are not associated with histological damage, creatinine increase or transplant complications during the first year.