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Selected Works of Dr. Vivian McAlister O.C.
Article
Angiotensin II Type I Receptor Agonistic Autoantibodies are Associated with Poor Allograft Survival in Liver Retransplantation.
American Journal of transplantation (2019)
  • Qingyong Xu, Western University
  • Vivian C. McAlister, Western University
  • Steve Leckie, Western University
  • Anton Skaro, Western University
  • Paul Marotta, The University of Western Ontario
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Abstract
Angiotensin II type I receptor (AT1R) agonistic autoantibodies (AT1R-AA) are detrimental to kidney transplantation. Early studies suggested a similar negative effect in primary liver transplantation. Here, we studied AT1R-AA in a retrospective cohort of 94 patients who received a second liver transplant to determine their prevalence and effects. The concentrations of preformed AT1R-AA before transplantation were higher (p=0.019) in the 48 patients who lost their liver grafts than in the 46 patients whose grafts survived. About half (48/94, 51.1%) of the patients were positive for AT1R-AA>17U/ml before the second liver transplantation. In 22 (23.4%) patients, strong positive AT1R-AA (defined as >40U/ml) were detected, of whom 16 (72.7%) patients lost their grafts. Based on Kaplan-Meier analysis, patients with strong positive AT1R-AA had significantly worse graft survival than those with AT1R-AA<40U/ml (p=0.035). In multivariate Cox models that included confounders such as sex and age, either AT1R-AA>40U/ml [HR=1.999 (1.085-3.682), p=0.026] or increased concentrations of AT1R-AA [HR=1.003 (1.001-1.006) per incremental U/ml, p=0.019] were significantly associated with elevated risk for graft loss. In conclusion, our data indicate that there is a high prevalence of AT1R-AA in candidates for second liver transplantation and that their presence is associated with inferior long-term outcomes of the second graft. This article is protected by copyright. All rights reserved.
Keywords
  • liver transplantation,
  • autoantibodoes,
  • angiotensin,
  • Angiotensin II type I receptor (AT1R)
Disciplines
Publication Date
August, 2019
DOI
10.1111/ajt.15571
Citation Information
Qingyong Xu, Vivian C. McAlister, Steve Leckie, Anton Skaro, et al.. "Angiotensin II Type I Receptor Agonistic Autoantibodies are Associated with Poor Allograft Survival in Liver Retransplantation." American Journal of transplantation (2019)
Available at: http://works.bepress.com/vivianmcalister/274/