Predictive value of HLA antibodies and serum creatinine in chronic rejection: results of a 2-year prospective trial

Transplantation. 2005 Nov 15;80(9):1194-7. doi: 10.1097/


In this large collaborative study, 2,231 transplanted patients with functioning kidneys were tested for HLA antibodies, then examined 2 years later for graft survival. Among 478 patients with antibodies, 15.1% failed in 2 years, compared to 6.8% failure in 1,753 patients without antibodies (P=0.00000002). Cytotoxicity testing correlated better with outcome than flow cytometry or ELISA testing on HLA coated beads, possibly because it detected non-HLA antigens. When the patients were further broken down into those with serum creatinine at the time of testing of 0.5-1.9, 4.4% of antibody patients failed at 2 years, compared to 4.3% of patients without antibodies. This 0.1% difference increased among patients with serum creatinine values of 2.0-2.9 to 17.9%, and among those with 3.0-3.9 to 16.3%. We conclude that HLA antibodies posttransplantation is predictive of subsequent graft failure, and its predictive value can be enhanced among patients with higher serum creatinine values.

MeSH terms

  • Antibodies / blood*
  • Chronic Disease
  • Creatinine / blood*
  • Graft Rejection / blood*
  • Graft Rejection / etiology*
  • Graft Survival
  • HLA Antigens / immunology*
  • Humans
  • Kidney Transplantation / adverse effects*
  • Predictive Value of Tests
  • Prospective Studies


  • Antibodies
  • HLA Antigens
  • Creatinine