Toward a sensible single antigen bead cut-off based on kidney graft survival

Background There is no consensus in the literature on the interpretation of single antigen bead (SAB) positive for a specific HLA antibody. Methods To inform the debate, we studied the relationship between various SAB positivity algorithms and the impact of resulting donor-specific HLA antibody (DSA) positivity on long-term kidney graft survival in 3237 deceased-donor transplants. Results First, we showed that the interassay variability can be greatly reduced when working with signal-to-background ratios instead of absolute MFIs. Next, we determined pretransplant DSA using various MFI cut-offs, signal-to-background ratios (STBR) and combinations thereof. The impact of the various cut-offs was studied by comparing the graft survival between the DSA-positive and DSA-negative groups. We did not observe a strong impact of various cut-off levels on 10-year graft survival. A stronger relationship between the cut-off level and 1-year graft survival for DSA-positive transplants was found when using STBR, most pronounced for the bead of the same HLA-locus with lowest MFI taken as background. Conclusions With respect to pretransplant risk stratification, we propose a SBTR-6 (using the bead of the same HLA-locus with lowest MFI as background) cut-off of 15 combined with an MFI cut-off of 500, resulting in 8% and 21% lower 1- and 10-years graft survival, respectively, for 8% DSA positive transplants. Corresponding author: E-mail address: H.G.Otten@umcutrecht.nl. Corresponding author permanent address: Laboratory of Translational Immunology, University Medical Center Utrecht, F.03.821, P.O. Box 85500, 3508 GA Utrecht, The Netherlands. Tel.: +31 88 75 57680 Disclosure The authors of this manuscript have no conflicts of interest to disclose. Authorship Participated in research design: BW, EK, AD, LP, HO Participated in writing of the paper: BW, EK, IJ, WA, LH, AvZ, MV, MLB, BH, AL, LB, CR, CV, ItB, AH, SH, DR, FC, HO Participated in the performance of the research: BW, EK, AD, LP Contributed new reagents or analytic tools: BW, EK, IJ, WA, AvdM, LH, MCB, ES, CH, FvR, AvZ, MV, MLB, AD, LP, MS, JS, BH, AL, LB, CR, MT, CV, LW, EvD, MG, MC, FvI, AN, NL, WS, KvdP, NvdW, ItB, FB, AH, PvdB, JdF, MB, SH, DR, FC, HO Participated in data analysis: BW, EK, HO Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2P7LDbI

The Metabolic Syndrome and Health Behaviors in School Children Aged 13–16 Years in Ubon Ratchathani: UMeSIA Project

Metabolic Syndrome and Related Disorders, Ahead of Print.


https://ift.tt/2KPWYtG

Association of Thyroid Function and Autoimmunity with Ovarian Reserve in Women Seeking Infertility Care

Thyroid, Ahead of Print.


https://ift.tt/2MMEpIE

Surgical Confirmation of Incomplete Treatment for Primary Papillary Thyroid Carcinoma by Percutaneous Thermal Ablation: A Retrospective Case Review and Literature Review

Thyroid, Ahead of Print.


https://ift.tt/2MogmTq

Low Iodine Intake from Dairy Foods Despite High Milk Iodine Content in Israel

Thyroid, Volume 28, Issue 8, Page 1042-1051, August 2018.


https://ift.tt/2MNBbEA

Morgellons disease: A review of a mysterious psychodermatologic disorder

Introduction: Morgellons disease is a rare, unexplained skin disorder that whose specific etiology remains a mystery to both the Dermatologic and Psychiatric community as the specific etiology remains unknown. The condition is characterized by the physical presentation of painful sores with reported crawling sensations within the skin and the fixed belief of infection or parasitic infestation. The pathognomonic feature of this disease is the presence of filaments or fibers embedded in and emerging from these sores.

https://ift.tt/2MK5Xyo

Effectiveness of the Eczema Action Plan (EAP) in improving the Eczema Area and Severity Index (EASI) scores among pediatric patients with atopic dermatitis: A pragmatic randomized controlled trial

Introduction: Atopic dermatitis (AD) is a chronically relapsing skin disease that occurs most commonly during early infancy and childhood. Education about the condition is vital in helping patients and their caregivers understand the nature of the disease. Evidence show that adherence is poor. There are no reported studies on interventions done so far to increase treatment adherence among patients with atopic dermatitis in the local setting. This study aims to improve treatment adherence among patients with atopic dermatitis through improvement of the EASI scores.

https://ift.tt/2MjA03C