All chronic rejection failures of kidney transplants were preceded by the development of HLA antibodies

Transplantation. 2002 Oct 27;74(8):1192-4. doi: 10.1097/00007890-200210270-00025.


Background: Recent studies show that almost all patients who have rejected a kidney transplant had human leukocyte antigen (HLA) antibodies. In this study, we sought to determine whether patients develop HLA antibodies before chronic rejection.

Methods: For the past 8 years, 139 patients who had undergone kidney transplantation were systematically examined, using an enzyme-linked immunosorbent assay-based method, for the development of class-I and class-II HLA antibodies 3 months, 6 months, and yearly after transplantation. Chronic rejection was diagnosed by biopsy.

Results: Among 29 patients with chronic rejection, 100% of the patients had HLA antibodies before rejection. Of these patients, 14 patients developed antibodies de novo. In contrast, among 110 patients with stable function, 27% of the patients developed HLA antibodies posttransplant (P<0.001).

Conclusions: HLA antibodies were found in 29 consecutive cases of chronic rejection failures as much as one year before the loss of grafts. We conclude that HLA antibodies may be a prerequisite for chronic immunologic rejection.

MeSH terms

  • Autoantibodies / blood*
  • Chronic Disease
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Graft Rejection / etiology
  • Graft Rejection / immunology*
  • HLA Antigens / immunology*
  • Humans
  • Kidney Transplantation / immunology*
  • Male
  • Middle Aged
  • Treatment Failure


  • Autoantibodies
  • HLA Antigens