engleski

HLA donor specific antibodies in kidney transplantation

Human leukocyte antigen (HLA) system plays the critical part of the host immune defence mechanism and is used to match organ recipient with the most appropriate donor in organ transplantation. Mismatches (MM) in HLA system have the impact on graft survival as de novo formation of donor- specific antibodies (DSA) posttransplant can increase the risk for acute and chronic rejections. Eplets, the smallest functional units of epitopes, are in recent years also being considered in recipient-donor matching. We have retrospectively analysed the relationship between MMs at HLA-A, -B, -DRB1 and -DQB1 locus and the development of DSA in 47 kidney transplant patients that were negative for the presence of HLA antibodies before transplantation. Among 47 recipients, 40% developed DSA (DSA+) and among them, 63% developed only HLA class II antibodies. All HLA loci MM contributed to the development of HLA locus-specific antibodies, but HLA-DQ predominated, as 41% of recipients with HLA-DQ MM developed DSA. HLAMatchmaker analysis for HLA- DR/DQ eplet MM showed statistically significant difference between DSA- (N=33) and DSA+ recipients (N=14) for a total number of MM eplets (300 in DSA- vs 248 in DSA+) and for a median value (9 in DSA- vs 16.5 in DSA+). The results are indicating the importance of HLA-class II matching in kidney transplantation.

HLA ; DSA ; kidney transplantation

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