Tu85 - Long-term Impact of Atopy in Kidney Transplantation

Background. Atopy is a genetic condition predisposing individual to develop immunoglobulin E (IgE) against common inhalant allergens through Th2 polarization mechanisms. The impact of atopy on graft survival in solid organ transplantation is unknown.

Methodology. We retrospectively analyzed 285 renal allograft recipients with a 10-year follow-up from the Swiss Transplant Cohort Study, a prospective multicenter cohort for solid organ transplantation. A positive Phadiatop ( >0.35 KU/L) before transplantation defined atopic patients, a blood test measuring IgE antibodies to a mixture of common inhalant allergens (grass, tree, herbs, spores, animals and mite).

Results. Of 285 kidney transplant recipients, 70 individuals were atopic (24.6%). Atopic patients were significantly younger (58.0 vs 49.6-year-old, P = 0.002). No significant difference was found for gender, cold/warm ischemia time, preformed donor specific antibodies (DSA), HLA mismatches, induction and maintenance immunosuppressive therapy, CMV serostatus, and kidney failure cause. Ten-year patient and graft survival was increased in the atopic group, respectively 94.7% versus 78.8% (P = 0.005), and 90.4% versus 80.4% (P = 0.063). Multivariate Cox analysis revealed that atopy predicted patient survival independently of age and living donation. Finally, cumulative DSA was significantly lower in the atopic group.

Conclusion. Atopy was associated with longer recipients survival and graft outcomes independently of age and living donation, possibly by limiting DSA formation. Atopy may be a predictive factor for long-term kidney allograft survival.