Prevalence and significance of anti-HLA and donor-specific antibodies long-term after renal transplantation

Transpl Int. 2005 May;18(5):532-40. doi: 10.1111/j.1432-2277.2005.00085.x.

Abstract

Post-transplant circulating anti-human leukocyte antigens (HLA)-antibodies and C4d in allograft biopsies may be important in chronic rejection in renal transplant recipients (RTR). We determined the prevalence and significance of anti-HLA-antibodies and donor-specific antibodies (DSA). Sera were collected from 251 RTR >6 months post-transplant. Sera were tested using enzyme-linked immunosorbent assay (ELISA) screening for anti-HLA antibodies. Positive sera were retested with ELISA-specific panel for antibody specificity. A 11.2% of patients had anti-HLA antibodies and 4.4% had DSA. Anti-HLA antibodies were significantly associated with pretransplant sensitization, acute rejection and in multivariate analysis, higher serum creatinine (2.15 +/- 0.98 vs. 1.57 +/- 0.69 mg/dl in negative anti-HLA antibodies group). Allograft biopsies performed in a subset of patients with anti-HLA antibodies revealed that 66% had C4d in peritubular capillaries (0% in patients without antibodies). Anti-HLA antibodies were associated with a worse allograft function and in situ evidence of anti-donor humoral alloreactivity. Long-term RTR with an increase in creatinine could be screened for anti-HLA antibodies and C4d in biopsy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibody Specificity
  • Child
  • Child, Preschool
  • Chronic Disease
  • Complement C4b / metabolism
  • Cross-Sectional Studies
  • Female
  • Graft Rejection / etiology
  • Graft Rejection / immunology
  • HLA Antigens / immunology*
  • Humans
  • Isoantibodies / blood*
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / immunology*
  • Male
  • Middle Aged
  • Peptide Fragments / metabolism
  • Time Factors
  • Tissue Donors

Substances

  • HLA Antigens
  • Isoantibodies
  • Peptide Fragments
  • Complement C4b
  • complement C4d