AUTHOR=Mawad Habib , Pinard Louis , Medani Samar , Chagnon Miguel , Boucquemont Julie , Turgeon Julie , Dieudé Mélanie , Hamelin Katia , Rimbaud Annie Karakeussian , Belayachi Ali , Yang Bing , Collette Suzon , Sénécal Lynne , Foster Bethany J. , Hébert Marie-Josée , Cardinal Héloïse TITLE=Hypothermic Perfusion Modifies the Association Between Anti-LG3 Antibodies and Delayed Graft Function in Kidney Recipients JOURNAL=Transplant International VOLUME=36 YEAR=2023 URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2023.10749 DOI=10.3389/ti.2023.10749 ISSN=1432-2277 ABSTRACT=

We previously reported associations between autoantibodies to the LG3 fragment of perlecan, anti-LG3, and a higher risk of delayed graft function (DGF) in kidney transplant recipients. Here, we aimed to determine whether some factors that modulate ischemia-reperfusion injury (IRI) can modify this association. We performed a retrospective cohort study in kidney transplant recipients in 2 university-affiliated centers. In 687 patients, we show that high pre-transplant anti-LG3 are associated with DGF when the kidney is transported on ice (odds ratio (OR): 1.75, 95% confidence interval 1.02–3.00), but not when placed on hypothermic perfusion pump (OR: 0.78, 95% CI 0.43–1.37). In patients with DGF, high pre-transplant anti-LG3 are associated with a higher risk of graft failure (subdistribution hazard ratio (SHR): 4.07, 95% CI: 1.80, 9.22), while this was not the case in patients with immediate graft function (SHR: 0.50, 95% CI 0.19, 1.29). High anti-LG3 levels are associated with a higher risk of DGF in kidneys exposed to cold storage, but not when hypothermic pump perfusion is used. High anti-LG3 are also associated with a higher risk of graft failure in patients who experience DGF, a clinical manifestation of severe IRI.