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- Title
The significance of pretransplant donor-specific antibodies reactive with intact or denatured human leucocyte antigen in kidney transplantation.
- Authors
Otten, H. G.; Verhaar, M. C.; Borst, H. P. E.; Eck, M.; Ginkel, W. G. J.; Hené, R. J.; Zuilen, A. D.
- Abstract
Antibodies recognizing denatured human leucocyte antigen ( HLA) can co-react with epitopes on intact HLA or recognize cryptic epitopes which are normally unaccessible to HLA antibodies. Their specificity cannot be distinguished by single antigen beads ( SAB) alone, as they carry a mixture of intact and denatured HLA. In this study, we selected pretransplant sera containing donor-specific HLA class I antibodies ( DSA) according to regular SAB analysis from 156 kidney transplant recipients. These sera were analysed using a SAB preparation (i Beads) which is largely devoid of denatured HLA class I, and SAB coated with denatured HLA class I antigens. A total of 241 class I DSA were found by regular SAB analysis, of which 152 (63%) were also found by i Beads, whereas 28 (11%) were caused by reactivity with denatured DNA. Patients with DSA defined either by regular SAB or i Beads showed a significantly lower graft survival rate ( P = 0·007) compared to those without HLA class I DSA, whereas reactivity to exclusively denatured HLA was not associated with decreased graft survival. In addition, DSA defined by reactivity to class I SAB or class I i Beads occurred more frequently in female patients and in patients with historic HLA sensitization, whereas reactivity to denatured HLA class I was not associated with any of these parameters. Our data suggest that pretransplant donor-specific antibodies against denatured HLA are clinically irrelevant in patients already sensitized against intact HLA.
- Subjects
HLA histocompatibility antigens; KIDNEY transplantation; IMMUNOGLOBULINS; EPITOPES; DNA; ORGAN donors; MEDICAL statistics
- Publication
Clinical & Experimental Immunology, 2013, Vol 173, Issue 3, p536
- ISSN
0009-9104
- Publication type
Article
- DOI
10.1111/cei.12127