Serum major-histocompatibility-complex class Ⅰ-related chain A antibody detection for the evaluation of graft dysfunction in renal allograft recipients

• Published in: Chinese medical journal Vol. 124; no. 14; pp. 2127 - 2131
• Main Authors: Zhang, Ming, Lu, Fu-ming, Qu, Lian-xi, He, Jun, Yuan, Xiao-niao, Gu, Yong
• Format: Journal Article
• Language: English
• Published: China Department of Nephrology,Huashan Hospital, Fudan University, Shanghai 200040, China%Department of Urology,Huashan Hospital, Fudan University, Shanghai 200040, China%Jiangsu Institute of Hematology, Affiliated First Hospital, Soochow University, Suzhou, Jiangsu 215006, China 20.07.2011
• Subjects: Adult; Antibodies - blood; Antibodies - immunology; Female; Histocompatibility Antigens Class I - immunology; Humans; Kidney Transplantation - immunology; Male; Middle Aged; Prospective Studies; Transplantation, Homologous - immunology; 主要组织相容性复合体; 人类白细胞抗原; 功能障碍; 抗体检测; 植物; 肾移植; 血清; 表皮生长因子受体; acute rejection; anti-HLA antibodies; major-histocompatibility-complex class Ⅰ-related chain A antibody; renal transplantation
• ISSN: 0366-6999; 2542-5641
• DOI: 10.3760/cma.j.issn.0366-6999.2011.14.009

Background In addition to the well-known antibodies against human leukocyte antigens （HLA）-induced kidney-graft rejection, polymorphic major-histocompatibility-complex （MHC） class Ⅰ-related chain A （MICA） antigens can elicit antibodies and have been suggested to play a role in the antibody-mediated allograft rejection （AMR）. We carded out a prospective study of MICA antibodies in post-renal transplant patients to determine the association between MICA antibodies, C4d staining, histological features, and graft outcome.Methods We tested 52 patients who had biopsy results due to graft dysfunction. The MICA antibodies in concurrent sera were determined by Luminex. All patients were followed up for one year after renal biopsy. The influence of antibody production on the function of graft was analyzed.Results Antibodies against MICA were positive in 15 out of the 52 patients （28.9%）. The presence of MICA antibodies was associated with renal-allograft deterioration. During one-year follow-up, the estimated glomerular filtration rate （eGFR） decreased （24.0±3.4）% among recipients with anti-MICA antibodies. However, among recipients without anti-MICA antibodies, the eGFR has declined only （8.4＋3.0）% （P=0.017）. The association between C4d staining,histological features and MICA antibody production was found no significant difference.Conclusion Besides anti-HLA antibodies, the presence of post-transplant MICA antibody is associated with poor graft outcome and increases the risk of graft failure.