Journal article
Donor specific antibody surveillance among pediatric kidney transplant programs: A report from the improving renal outcome collaborative
Pediatric transplantation, Vol.27(3), e14498
05/2023
DOI: 10.1111/petr.14498
PMCID: PMC10305844
PMID: 36898856
Appears in UI Libraries Support Open Access
Abstract
Kidney transplantation (KT) is the preferred treatment for children with end-stage kidney disease. Recent advances in immunosuppression and advances in donor specific antibody (DSA) testing have resulted in prolonged allograft survival; however, standardized approaches for surveillance DSA monitoring and management of de novo (dn) DSA are widely variable among pediatric KT programs.
Pediatric transplant nephrologists in the multi-center Improving Renal Outcomes Collaborative (IROC) participated in a voluntary, web-based survey between 2019 and 2020. Centers provided information pertaining to frequency and timing of routine DSA surveillance and theoretical management of dnDSA development in the setting of stable graft function.
29/30 IROC centers responded to the survey. Among the participating centers, screening for DSA occurs, on average, every 3 months for the first 12 months post-transplant. Antibody mean fluorescent intensity and trend most frequently directed changes in patient management. Increased creatinine above baseline was reported by all centers as an indication for DSA assessment outside of routine surveillance testing. 24/29 centers would continue to monitor DSA and/or intensify immunosuppression after detection of antibodies in the setting of stable graft function. In addition to enhanced monitoring, 10/29 centers reported performing an allograft biopsy upon detection of dnDSA, even in the setting of stable graft function.
This descriptive report is the largest reported survey of pediatric transplant nephrologist practice patterns on this topic and provides a reference for monitoring dnDSA in the pediatric kidney transplant population.
Details
- Title: Subtitle
- Donor specific antibody surveillance among pediatric kidney transplant programs: A report from the improving renal outcome collaborative
- Creators
- Emily J Steinbach - Division of Nephrology, Dialysis, and Transplantation, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USAGina M Barletta - Phoenix Children's HospitalHiren P Patel - Nationwide Children's HospitalDavid K Hooper - University of CincinnatiRouba Garro - Children's Healthcare of AtlantaLyndsay A Harshman - Division of Nephrology, Dialysis, and Transplantation, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa, USA
- Resource Type
- Journal article
- Publication Details
- Pediatric transplantation, Vol.27(3), e14498
- DOI
- 10.1111/petr.14498
- PMID
- 36898856
- PMCID
- PMC10305844
- NLM abbreviation
- Pediatr Transplant
- ISSN
- 1397-3142
- eISSN
- 1399-3046
- Publisher
- Wiley
- Grant note
- National Institute of Diabetes and Digestive and Kidney Diseases
- Language
- English
- Electronic publication date
- 03/10/2023
- Date published
- 05/2023
- Academic Unit
- Nephrology, Dialysis and Transplantation; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Biology; Radiation Oncology
- Record Identifier
- 9984375357502771
Metrics
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