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de Nattes T, Kaveri R, Farce F, François A, Guerrot D, Hanoy M, Laurent C, Candon S, Bertrand D. Daratumumab for antibody-mediated rejection: Is it time to target the real culprit? Am J Transplant 2023; 23:1990-1994. [PMID: 37414251 DOI: 10.1016/j.ajt.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/08/2023]
Abstract
We report the case of a sensitized woman who underwent successful transplantation after a desensitization protocol, with an optically normal 8-day biopsy. At 3 months, she developed active antibody-mediated rejection (AMR) due to preformed donor-specific antibodies. It was decided to treat the patient with daratumumab, an anti-CD38 monoclonal antibody. The mean fluorescence intensity of donor-specific antibodies decreased, pathologic signs of AMR regressed, and kidney function returned to normal. A molecular assessment of biopsies was retrospectively performed. By doing so, regression of the molecular signature of AMR was evidenced between the second and third biopsies. Interestingly, the first biopsy revealed a gene expression profile of AMR, which helped retrospectively classify this biopsy as AMR, illustrating the relevance of molecular phenotyping of biopsy in high-risk situations such as desensitization.
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Affiliation(s)
- Tristan de Nattes
- Univ Rouen Normandie, INSERM U1234, CHU Rouen, Service de Néphrologie, Rouen, France.
| | - Rangolie Kaveri
- EFS Hauts de France-Normandie, Service d'Histocompatibilité, Rouen, France
| | - Fabienne Farce
- EFS Hauts de France-Normandie, Service d'Histocompatibilité, Rouen, France
| | | | - Dominique Guerrot
- Univ Rouen Normandie, INSERM U1096, CHU Rouen, CIC-CRB 1404, Service de Néphrologie, Rouen, France
| | | | | | - Sophie Candon
- Univ Rouen Normandie, INSERM U1234, CHU Rouen, Service d'Immunologie et de Biothérapies, Rouen, France
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Bertrand D, Hamzaoui M, Lemée V, Lamulle J, Laurent C, Etienne I, Lemoine M, Lebourg L, Hanoy M, Le Roy F, Nezam D, Farce F, Plantier JC, Boyer O, Guerrot D, Candon S. Antibody and T-cell response to a third dose of SARS-CoV-2 mRNA BNT162b2 vaccine in kidney transplant recipients. Kidney Int 2021; 100:1337-1340. [PMID: 34619232 PMCID: PMC8489274 DOI: 10.1016/j.kint.2021.09.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Dominique Bertrand
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France.
| | - Mouad Hamzaoui
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Veronique Lemée
- Department of Virology, Rouen University Hospital, Rouen, France
| | - Julie Lamulle
- Department of Immunology and Biotherapies, Rouen University Hospital, Rouen, France
| | - Charlotte Laurent
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Isabelle Etienne
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mathilde Lemoine
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Ludivine Lebourg
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mélanie Hanoy
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Frank Le Roy
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Dorian Nezam
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Fabienne Farce
- HLA Laboratory, Etablissement Français du Sang (EFS) Normandie, Rouen, France
| | | | - Olivier Boyer
- Department of Immunology and Biotherapies, Rouen University Hospital, Rouen, France; INSERM U1234, University of Rouen Normandy, Rouen, France
| | - Dominique Guerrot
- Department of Nephrology, Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Sophie Candon
- Department of Immunology and Biotherapies, Rouen University Hospital, Rouen, France; INSERM U1234, University of Rouen Normandy, Rouen, France
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Jacob V, Farce F, Kaveri R, Desoutter J, Guillaume N. Characterization of the novel HLA-DQA1*01:80 allele by next generation sequencing. HLA 2021; 99:68-69. [PMID: 34510809 DOI: 10.1111/tan.14428] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 11/30/2022]
Abstract
HLA-DQA1*01:80 differs from HLA-DQA1*01:04:01 by one nucleotide substitution in codon -18 in exon 1.
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Affiliation(s)
- Valentine Jacob
- Department of Hematology and Histocompatibility, Amiens University Medical Center, Amiens, France.,EA HEMATIM 4666, Jules Verne University of Picardie, Amiens, France
| | - Fabienne Farce
- Department of Histocompatibility, EFS Hauts de France-Normandie, Rouen, France
| | - Rangolie Kaveri
- Department of Histocompatibility, EFS Hauts de France-Normandie, Rouen, France
| | - Judith Desoutter
- Department of Hematology and Histocompatibility, Amiens University Medical Center, Amiens, France
| | - Nicolas Guillaume
- Department of Hematology and Histocompatibility, Amiens University Medical Center, Amiens, France.,EA HEMATIM 4666, Jules Verne University of Picardie, Amiens, France
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Jacob V, Farce F, Kaveri R, Desoutter J, Guillaume N. Characterization of the novel HLA-C*04:438 allele by next generation sequencing. HLA 2021; 99:53-54. [PMID: 34498811 DOI: 10.1111/tan.14425] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 11/29/2022]
Abstract
HLA-C*04:438 differs from HLA-C*04:01:01 by one nucleotide substitution in codon 237 in exon 4.
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Affiliation(s)
- Valentine Jacob
- Department of Hematology and Histocompatibility, Amiens University Medical Center, Amiens, France.,EA HEMATIM 4666, Jules Verne University of Picardie, Amiens, France
| | - Fabienne Farce
- Department of Histocompatibility, EFS Hauts de France-Normandie, Rouen, France
| | - Rangolie Kaveri
- Department of Histocompatibility, EFS Hauts de France-Normandie, Rouen, France
| | - Judith Desoutter
- Department of Hematology and Histocompatibility, Amiens University Medical Center, Amiens, France
| | - Nicolas Guillaume
- Department of Hematology and Histocompatibility, Amiens University Medical Center, Amiens, France.,EA HEMATIM 4666, Jules Verne University of Picardie, Amiens, France
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Bertrand D, Kaveri R, Laurent C, Gatault P, Jauréguy M, Garrouste C, Sayegh J, Bouvier N, Caillard S, Lanfranco L, Thierry A, François A, Hau F, Etienne I, Guerrot D, Farce F. Intensity of de novo DSA detected by Immucor Lifecodes assay and C3d fixing antibodies are not predictive of subclinical ABMR after Kidney Transplantation. PLoS One 2021; 16:e0249934. [PMID: 33886604 PMCID: PMC8062066 DOI: 10.1371/journal.pone.0249934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/27/2021] [Indexed: 01/06/2023] Open
Abstract
De novo donor-specific antibodies (dnDSA) are associated with antibody-mediated rejection (ABMR) and allograft loss. We tested Immucor* (IM) Luminex Single-antigen beads (LSAB) assay and C3d-fixing antibodies in the setting of dnDSA and subclinical (s) ABMR. This retrospective multicentric study included 123 patients biopsied because of the presence of subclinical de novo DSA detected by One Lamda* Labscreen (MFI > 1000). In 112 patients, sera of the day of the biopsy were available and tested in a central lab with IM Lifecodes LSAB and C3d fixing antibodies assays. In 16 patients (14.3%), no DSA was detected using Immucor test. In 96 patients, at least one DSA was determined with IM. Systematic biopsies showed active sABMR in 30 patients (31.2%), chronic active sABMR in 17 patients (17.7%) and no lesions of sABMR in 49 KT recipients (51%). Intensitity criteria (BCM, BCR and AD-BCR) of DSA were not statistically different between these 3 histological groups. The proportion of patients with C3d-fixing DSA was not statistically different between the 3 groups and did not offer any prognostic value regarding graft survival. Performing biopsy for dnDSA could not be guided by the intensity criteria of IM LSAB assay. C3d-fixing DSA do not offer added value.
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Affiliation(s)
- Dominique Bertrand
- Nephrology Kidney Transplantation Dialysis, CHU Rouen, Rouen, France
- * E-mail:
| | | | - Charlotte Laurent
- Nephrology Kidney Transplantation Dialysis, CHU Rouen, Rouen, France
| | | | - Maïté Jauréguy
- Nephrology Kidney Transplantation, CHU Amiens, Amiens, France
| | - Cyril Garrouste
- Nephrology Kidney Transplantation, CHU Clermont Ferrand, Clermont Ferrand, France
| | - Johnny Sayegh
- Nephrology Kidney Transplantation, CHU Angers, Angers, France
| | | | - Sophie Caillard
- Nephrology Kidney Transplantation, CHU Strasbourg, Strasbourg, France
| | - Luca Lanfranco
- Nephrology Kidney Transplantation, CHU Brest, Brest, France
| | - Antoine Thierry
- Nephrology Kidney Transplantation, CHU Poitiers, Poitiers, France
| | | | | | - Isabelle Etienne
- Nephrology Kidney Transplantation Dialysis, CHU Rouen, Rouen, France
| | - Dominique Guerrot
- Nephrology Kidney Transplantation Dialysis, CHU Rouen, Rouen, France
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Bertrand D, Farce F, Étienne I, Laurent C, François A, Hamelin F, Guerrot D, Hau F. Comparaison de deux tests Luminex d’identification d’anticorps spécifiques du donneur devant une forte suspicion de rejet humoral en transplantation rénale. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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