Why is my Allosure number 2.4 but creatinine 1.4 and biopsy shows no rejection?

[Norken]

Hi. I am one year out, 99% HLAs. It's been a rodeo ride this last year because of my antibodies. This last year I have had 4 Allosure tests and underwent plasmapheresis and Rituxan treatments. The last Allosure shows 2.4 which is a pretty high rejection number. My creatinine has been consistent between 1.3 and 1.7 for the last year and my last biopsy (I've had three in the last year) shows no rejection. Doctors are "very concerned" about the Allosure number and are trying to find the cause of the high number. Anyone have any insight or experience with Allosure they can share. Thanks!

[LisaSnow]

What do you mean by "99% HLAs. "?

Allosure is a probability game that depends on how "White" you are. The mathematics the company uses to calculate risk is based on almost all Caucasian's genotype frequency, so if you are a person of color and your donor is not, the prediction is likely false "positive" (more than 1 in score). I would NOT worry if your biopsy shows no rejection and your function is stable. Do you test positive for Donor specific antibodies?

[Norken in reply to LisaSnow]

Thanks for the response. Pre-Transplant my HLA (Human Leukocyte Antigen) antibodies, were 99% making a match very difficult because my antibodies would be very aggressive to any kidney that was less than my HLAs. I was put on a national, not regional, list because of how high my HLAs were. I was not told anything about my donor so I do not know if they were the same race as me or not. My DSAs were above normal when I was in rejection last May. After plasmapheresis, my DSA dropped to negative. They are running labs on me on Friday and I know DSA was one of them. I try not to worry, but...you know how it goes. Some days the negative news gets in my head.

[LisaSnow in reply to Norken]

Yes please try not to worry. Even with DSA as a risk they have treatments and it was successful on you. Did they also increase your tacrolimus and other meds?

[Norken in reply to LisaSnow]

Good morning. Yes, they did increase my tacrolimus but not my cellcept since I'm still on the original high dose. Thanks for the reassurance about the DSA treatments. It made me remember what one of my doctors told me, that some people (more than likely me) with super high antibodies need to have their antibodies wiped out every few months or years via plasmapheresis. I've been through that already and it's not as bad as dialysis, so all in all, it's a win. Every day not on dialysis is a win for me! I just wish I knew what is triggering the Allosure to go off the charts. I guess time will tell.