Association of HLA phenotypes of end-stage renal disease patients preparing for first transplantation with anti-HLA antibody status

• Published in: Renal failure Vol. 32; no. 3; pp. 380 - 383
• Main Authors: Karahan, Gonca Emel, Kekik, Cigdem, Oguz, Fatma Savran, Onal, Ayse Emel, Bakkalo lu, Hüseyin, Çali kan, Ya ar Kerem, Yazici, Halil, Turkmen, Aydin, Aydin, Ali Emin, Sever, Mehmet S., Eldegez, Ulug, Carin, Mahmut Nezih
• Format: Journal Article
• Language: English
• Published: England Informa UK Ltd 01.04.2010; Taylor & Francis
• Subjects: Adult; anti-HLA antibody; end-stage renal disease; Female; Histocompatibility; HLA Antigens - immunology; HLA phenotype; Humans; Isoantibodies - blood; Kidney Failure, Chronic - immunology; Kidney Failure, Chronic - surgery; Kidney Transplantation - immunology; Male; panel reactive antibody; Phenotype; renal transplantation
• ISSN: 0886-022X; 1525-6049
• DOI: 10.3109/08860221003615803

Patients with pre-transplantation high levels of panel reactive antibody (PRA) have an increased risk of graft failure, and renal transplantation in sensitized patients remains a highly significant challenge worldwide. The influence of anti-human leukocyte antigen (HLA) antibodies on the development of rejection episodes depends on patient-specific clinical factors and differs from patient to patient. The HLA typing of the recipient might influence the development of anti-HLA antibodies. Some HLA antigens appear to be more immunogenic than others. The aim of this study is to demonstrate the distribution of HLA phenotypes in PRA-positive and PRA-negative end-stage renal disease (ESRD) patients on the basis of having sensitizing events or not. Our study included 642 (mean age: 41.54; female male: 310 332) ESRD patients preparing for the first transplantation and who are on the cadaveric kidney transplantation waiting list of Istanbul Medical Faculty in 2008-2009. Class I HLA-A,B typing was performed by complement-dependent cytotoxicity (CDC) method, whereas class II HLA-DRB1 typing was performed by low-resolution polymerase chain reaction (PCR)-sequence-specific primer (SSP). All serum samples were screened for the presence of IgG type of anti-HLA class I- and II-specific antibodies by enzyme-linked-immunosorbent assay (ELISA). PRA-negative group consisted of 558 (86.9%) and PRA-positive group included 84 (13.1%) patients. We have found statistically significant frequency of HLA-A3 (p = 0.018), HLA-A66 (p = 0.04), and HLA-B18 (p = 0.006) antigens in PRA-positive patients and DRB1*07 (p = 0.02) having the highest frequency in patients with sensitizing event history but no anti-HLA development suggesting that DRB1*07 might be associated with low risk of anti-HLA antibody formation.