Huanxi Zhang1, Shuyi Wang2, Xiaojun Su1, Qian Fu1, Jun Li1, Jiali Wang3, Ronghai Deng1, Chenglin Wu1, Qingshan Huang4, Longshan Liu5, Changxi Wang6. 1. Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. 2. Department of Rheumatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. 3. Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. 4. Medical Information Institute, Sun Yat-sen University, Guangzhou, China. 5. Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory on Organ Donation and Transplant Immunology, Guangzhou, China; Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), Guangzhou, China. Electronic address: liulshan@mail.sysu.edu.cn. 6. Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory on Organ Donation and Transplant Immunology, Guangzhou, China; Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), Guangzhou, China. Electronic address: wangchx@mail.sysu.edu.cn.
Abstract
BACKGROUND: We conducted a meta-analysis to evaluate the predictive value of serum soluble B cell-activating factor (sBAFF) for antibody-mediated rejection (ABMR), which remains controversial. METHODS: Systematic literature search was performed in PubMed, EMBASE, Scopus, Cochrane Library, Web of Science and three Chinese databases. Studies of any relevant design were included. Random and fixed-effects meta-analytical models were used. Study quality, publication bias, and heterogeneity were assessed. This study was registered with PROSPERO (CRD42019109198). RESULTS: Nine observational studies were included in the meta-analysis, including 1302 cases (median NOS quality score = 8, range 6-8). The incidence of ABMR was significantly higher in the high sBAFF group than in the low sBAFF level group (Risk ratio [RR] 2.04 [95% CI 1.52-2.74], I2 = 26%, P < 0.01, N = 1014). The subgroup analysis showed that regardless of pre-transplant donor-specific antibody (DSA) status, the high sBAFF level group still had a significantly higher incidence of ABMR. sBAFF was not associated with the risk of TCMR. The sBAFF level was significantly higher in the anti-HLA-antibody (+) group than in anti-HLA-antibody (-) patients before or after kidney transplantation (Standardized mean difference [SMD] 0.43 [0.29-0.56], P < 0.01, I2 = 34%, N = 1001). CONCLUSION: sBAFF is a promising biomarker to further stratify the risk of ABMR post-renal transplant.
BACKGROUND: We conducted a meta-analysis to evaluate the predictive value of serum soluble B cell-activating factor (sBAFF) for antibody-mediated rejection (ABMR), which remains controversial. METHODS: Systematic literature search was performed in PubMed, EMBASE, Scopus, Cochrane Library, Web of Science and three Chinese databases. Studies of any relevant design were included. Random and fixed-effects meta-analytical models were used. Study quality, publication bias, and heterogeneity were assessed. This study was registered with PROSPERO (CRD42019109198). RESULTS: Nine observational studies were included in the meta-analysis, including 1302 cases (median NOS quality score = 8, range 6-8). The incidence of ABMR was significantly higher in the high sBAFF group than in the low sBAFF level group (Risk ratio [RR] 2.04 [95% CI 1.52-2.74], I2 = 26%, P < 0.01, N = 1014). The subgroup analysis showed that regardless of pre-transplant donor-specific antibody (DSA) status, the high sBAFF level group still had a significantly higher incidence of ABMR. sBAFF was not associated with the risk of TCMR. The sBAFF level was significantly higher in the anti-HLA-antibody (+) group than in anti-HLA-antibody (-) patients before or after kidney transplantation (Standardized mean difference [SMD] 0.43 [0.29-0.56], P < 0.01, I2 = 34%, N = 1001). CONCLUSION: sBAFF is a promising biomarker to further stratify the risk of ABMR post-renal transplant.
Authors: Juan Irure-Ventura; David San Segundo; Emilio Rodrigo; David Merino; Lara Belmar-Vega; Juan Carlos Ruiz San Millán; Rosalía Valero; Adalberto Benito; Marcos López-Hoyos Journal: Int J Mol Sci Date: 2020-01-25 Impact factor: 5.923