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THREE YEAR FOLLOW-UP ON PROSPECTIVE CHRONIC REJECTION STUDY.
Paul I. Terasaki Ph.D. 1 and Miyuki Ozawa B.S. 1. 1 Research Dept., Terasaki Foundation Laboratory, Los Angeles, CA, USA .
June 2005 will be 3 years since 2,231 patients were tested for HLA antibodies post transplantation in a prospective chronic rejection study. We are now in the process of obtaining the 3 year results, but the 2 year follow-up results were accumulated and summarized recently as shown in the graph. Those patients with antibodies had a lower graft survival than those without antibodies (Fig.a). This result was enhanced by including the serum creatinine (SCr) values at the time of antibody testing. As shown in Fig b, if the SCr values were low, there was no effect of antibodies. We interpret this to mean that in a non-damaged endothelium (insert b), within 2 years, antibody cannot close off the vessel. However, as the endothelium is further damaged as in Fig c, and d, with higher SCr, the effect of antibody results in failure in the subsequent 2 years.
It is remarkable that only one testing 2 years previously for HLA antibodies was so strongly correlated with outcome. We are in the process of gathering 3 year data, which will be available in the next several months, and will be reported at the time of the meeting. From the 2 year results, we conclude testing for HLA antibodies post transplantation is a valuable predictor of chronic immunologic rejection.