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  • Title: Evolution of donor-specific antibodies (DSA) and incidence of de novo DSA in solid organ transplant recipients after switch to everolimus alone or associated with low dose of calcineurin inhibitors.
    Author: Perbos E, Juinier E, Guidicelli G, Dromer C, Merville P, Billes MA, Taupin JL, Neau-Cransac M.
    Journal: Clin Transplant; 2014 Sep; 28(9):1054-60. PubMed ID: 25040585.
    Abstract:
    BACKGROUND: Everolimus (EVR) is used in organ transplantation to minimize calcineurin inhibitors (CNI). Some studies pointed out an increase in rejection and de novo donor-specific antibodies (DSA) incidence in kidney transplant patients after switch to EVR and CNI withdrawal. The aims of our study were to determine the evolution of anti-HLA antibodies and the incidence of de novo DSA in transplant recipients after conversion to EVR. METHODS: Heart, lung, kidney, and liver transplant recipients were included in a retrospective, monocentric case-control study. Anti-HLA antibodies were identified at transplantation, pre-switch, and at three, six, and 12 months post-switch. RESULTS: Conversion to EVR was performed about six yr after the transplant, and low-dose CNI was maintained in 60% of patients. We found no statistical difference for rejection, evolution of preformed anti-HLA antibodies or de novo DSA, after conversion to EVR or not. Incidence of anti-class II DSA tended to increase at month 12 whatever the immunosuppressive regimen. CONCLUSIONS: Late conversion to EVR appears to be safe and to not modify the natural evolution of anti-HLA antibodies in organ transplantation. As 60% of patients received EVR and low doses of CNI, it seems that such combinations could be used with a good outcome.
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