dc.contributor.author | Witczak, Bartlomiej J | |
dc.contributor.author | Pischke, Søren E. | |
dc.contributor.author | Reisæter, Anna V. | |
dc.contributor.author | Midtvedt, Karsten | |
dc.contributor.author | Ludviksen, Judith K | |
dc.contributor.author | Heldal, Kristian | |
dc.contributor.author | Jenssen, Trond | |
dc.contributor.author | Hartmann, Anders | |
dc.contributor.author | Åsberg, Anders | |
dc.contributor.author | Mollnes, Tom E. | |
dc.date.accessioned | 2022-02-14T10:01:49Z | |
dc.date.available | 2022-02-14T10:01:49Z | |
dc.date.issued | 2021-10-25 | |
dc.description.abstract | Background: The major reason for graft loss is chronic tissue damage, as interstitial fibrosis and tubular atrophy (IF/TA), where complement activation may serve as a mediator. The association of complement activation in a stable phase early after kidney transplantation with long-term outcomes is unexplored.<p>
<p>Methods: We examined plasma terminal C5b-9 complement complex (TCC) 10 weeks posttransplant in 900 patients receiving a kidney between 2007 and 2012. Clinical outcomes were assessed after a median observation time of 9.3 years [interquartile range (IQR) 7.5–10.6].<p>
<p>Results: Elevated TCC plasma values (≥0.7 CAU/ml) were present in 138 patients (15.3%) and associated with a lower 10-year patient survival rate (65.7% vs. 75.5%, P < 0.003). Similarly, 10-year graft survival was lower with elevated TCC; 56.9% vs. 67.3% (P < 0.002). Graft survival was also lower when censored for death; 81.5% vs. 87.3% (P = 0.04). In multivariable Cox analyses, impaired patient survival was significantly associated with elevated TCC [hazard ratio (HR) 1.40 (1.02–1.91), P = 0.04] along with male sex, recipient and donor age, smoking, diabetes, and overall survival more than 1 year in renal replacement therapy prior to engraftment. Likewise, elevated TCC was independently associated with graft loss [HR 1.40 (1.06–1.85), P = 0.02] along with the same covariates. Finally, elevated TCC was in addition independently associated with death-censored graft loss [HR 1.69 (1.06–2.71), P = 0.03] as were also HLA-DR mismatches and higher immunological risk.<p>
<p>Conclusions: Early complement activation, assessed by plasma TCC, was associated with impaired long-term patient and graft survival. | en_US |
dc.identifier.citation | Witczak BJ, Pischke, Reisæter, Midtvedt, Ludviksen JK, Heldal, Jenssen, Hartmann A, Åsberg, Mollnes. Elevated Terminal C5b-9 Complement Complex 10 Weeks Post Kidney Transplantation Was Associated With Reduced Long-Term Patient and Kidney Graft Survival. Frontiers in Immunology. 2021;12 | en_US |
dc.identifier.cristinID | FRIDAID 1948109 | |
dc.identifier.doi | 10.3389/fimmu.2021.738927 | |
dc.identifier.issn | 1664-3224 | |
dc.identifier.uri | https://hdl.handle.net/10037/24035 | |
dc.language.iso | eng | en_US |
dc.publisher | Frontiers Media | en_US |
dc.relation.journal | Frontiers in Immunology | |
dc.relation.projectID | Norges forskningsråd: 223255 | en_US |
dc.relation.projectID | info:eu-repo/grantAgreement/RCN/SFF/223255/Norway/Centre of Molecular Inflammation Research/CEMIR/ | en_US |
dc.rights.accessRights | openAccess | en_US |
dc.rights.holder | Copyright 2021 The Author(s) | en_US |
dc.title | Elevated Terminal C5b-9 Complement Complex 10 Weeks Post Kidney Transplantation Was Associated With Reduced Long-Term Patient and Kidney Graft Survival | en_US |
dc.type.version | publishedVersion | en_US |
dc.type | Journal article | en_US |
dc.type | Tidsskriftartikkel | en_US |
dc.type | Peer reviewed | en_US |