1. Analysis of de novo donor‐specific <scp>HLA‐DPB1</scp> antibodies in kidney transplantation
- Author
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Martin Zeier, Sabine Scherer, Thuong Hien Tran, Andrea Ruhenstroth, Caner Süsal, Arianeb Mehrabi, Chen Tang, Annette Fink, Christian Morath, Sofia Cinca, and Christian Unterrainer
- Subjects
Graft Rejection ,Immunology ,Human leukocyte antigen ,Epitope ,Isoantibodies ,Genetics ,medicine ,Humans ,Immunology and Allergy ,Typing ,Allele ,Gene ,Alleles ,HLA-DP beta-Chains ,Kidney transplantation ,Retrospective Studies ,HLA-DPB1 ,biology ,business.industry ,Histocompatibility Testing ,medicine.disease ,Kidney Transplantation ,biology.protein ,Antibody ,business - Abstract
HLA matching and avoidance of unacceptable mismatches are important aspects in the selection of donors for solid organ transplantation. The impact of HLA-DPB1 incompatibility on the outcomes of kidney transplantation is not fully understood. We investigated a potential effect of mismatching for HLA-DPB1 at allele, eplet, or Terasaki epitope (TerEp) level on the formation of de novo donor-specific antibodies (dnDSA) and also asked whether polymorphisms associated with HLA-DPB1 expression level may influence dnDSA induction. Furthermore, we analyzed the correlation between graft survival and HLA-DPB1 mismatches defined by different approaches. A cohort of 366 patients who received a kidney transplant at the Heidelberg University Hospital, Germany, with availability of pre- and post-transplant HLA antibody results by single antigen testing as well as of donor and recipient HLA-DPB1 high-resolution typing were analyzed retrospectively. Susceptibility to increased HLA-DPB1 expression was predicted by the linked dimorphism rs9277534 A/G of the HLA-DPB1 gene. Neither HLA-DPB1 mismatches at allele, eplet or TerEp level nor exposure to donor's high HLA-DPB1 expression were significantly associated with the risk of developing dnDSA against HLA-DPB1. However, HLA-DPB1 eplet and TerEp mismatches had a significant negative impact on graft survival (p < 0.001 and p = 0.003, respectively). Matching for HLA-DPB1 at epitope instead of allele level appears to have potential to improve graft survival in kidney transplantation.
- Published
- 2021