dc.date.accessioned | 2022-03-15T16:11:14Z | |
dc.date.available | 2022-03-15T16:11:14Z | |
dc.date.created | 2021-10-25T09:17:35Z | |
dc.date.issued | 2021 | |
dc.identifier.citation | Witczak, Bartlomiej J Pischke, Søren E. Reisæter, Anna V. Midtvedt, Karsten Ludviksen, Judith K Heldal, Kristian Jenssen, Trond Hartmann, Anders Åsberg, Anders Mollnes, Tom E. . Elevated Terminal C5b-9 Complement Complex 10 Weeks Post Kidney Transplantation Was Associated With Reduced Long-Term Patient and Kidney Graft Survival. Frontiers in Immunology. 2021, 12 | |
dc.identifier.uri | http://hdl.handle.net/10852/92487 | |
dc.description.abstract | Background The major reason for graft loss is chronic tissue damage, as interstitial fibrosis and tubular atrophy (IF/TA), where complement activation may serve as a mediator. The association of complement activation in a stable phase early after kidney transplantation with long-term outcomes is unexplored. Methods We examined plasma terminal C5b-9 complement complex (TCC) 10 weeks posttransplant in 900 patients receiving a kidney between 2007 and 2012. Clinical outcomes were assessed after a median observation time of 9.3 years [interquartile range (IQR) 7.5–10.6]. Results Elevated TCC plasma values (≥0.7 CAU/ml) were present in 138 patients (15.3%) and associated with a lower 10-year patient survival rate (65.7% vs . 75.5%, P < 0.003). Similarly, 10-year graft survival was lower with elevated TCC; 56.9% vs . 67.3% ( P < 0.002). Graft survival was also lower when censored for death; 81.5% vs . 87.3% ( P = 0.04). In multivariable Cox analyses, impaired patient survival was significantly associated with elevated TCC [hazard ratio (HR) 1.40 (1.02–1.91), P = 0.04] along with male sex, recipient and donor age, smoking, diabetes, and overall survival more than 1 year in renal replacement therapy prior to engraftment. Likewise, elevated TCC was independently associated with graft loss [HR 1.40 (1.06–1.85), P = 0.02] along with the same covariates. Finally, elevated TCC was in addition independently associated with death-censored graft loss [HR 1.69 (1.06–2.71), P = 0.03] as were also HLA-DR mismatches and higher immunological risk. Conclusions Early complement activation, assessed by plasma TCC, was associated with impaired long-term patient and graft survival. | |
dc.language | EN | |
dc.rights | Attribution 4.0 International | |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | |
dc.title | Elevated Terminal C5b-9 Complement Complex 10 Weeks Post Kidney Transplantation Was Associated With Reduced Long-Term Patient and Kidney Graft Survival | |
dc.type | Journal article | |
dc.creator.author | Witczak, Bartlomiej J | |
dc.creator.author | Pischke, Søren E. | |
dc.creator.author | Reisæter, Anna V. | |
dc.creator.author | Midtvedt, Karsten | |
dc.creator.author | Ludviksen, Judith K | |
dc.creator.author | Heldal, Kristian | |
dc.creator.author | Jenssen, Trond | |
dc.creator.author | Hartmann, Anders | |
dc.creator.author | Åsberg, Anders | |
dc.creator.author | Mollnes, Tom E. | |
cristin.unitcode | 185,53,18,12 | |
cristin.unitname | Avdeling for immunologi og transfusjonsmedisin | |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.fulltext | original | |
cristin.qualitycode | 1 | |
dc.identifier.cristin | 1948109 | |
dc.identifier.bibliographiccitation | info:ofi/fmt:kev:mtx:ctx&ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Frontiers in Immunology&rft.volume=12&rft.spage=&rft.date=2021 | |
dc.identifier.jtitle | Frontiers in Immunology | |
dc.identifier.volume | 12 | |
dc.identifier.doi | https://doi.org/10.3389/fimmu.2021.738927 | |
dc.identifier.urn | URN:NBN:no-95061 | |
dc.type.document | Tidsskriftartikkel | |
dc.type.peerreviewed | Peer reviewed | |
dc.source.issn | 1664-3224 | |
dc.identifier.fulltext | Fulltext https://www.duo.uio.no/bitstream/handle/10852/92487/2/Witczak%2BFrontImmunol2021.pdf | |
dc.type.version | PublishedVersion | |
cristin.articleid | 738927 | |
dc.relation.project | NFR/223255 | |