Article ; Online: HLA-DQ Mismatches Lead to More Unacceptable Antigens, Greater Sensitization, and Increased Disparities in Repeat Transplant Candidates.
Journal of the American Society of Nephrology : JASN
2022 Volume 33, Issue 12, Page(s) 2293–2305
Abstract: Background: In single-center studies, HLA-DQ mismatches stimulate the most pathogenic donor-specific antibodies. However, because of limitations of transplant registries, this cannot be directly confirmed with registry-based analyses.: Methods: We ... ...
| Abstract | Background: In single-center studies, HLA-DQ mismatches stimulate the most pathogenic donor-specific antibodies. However, because of limitations of transplant registries, this cannot be directly confirmed with registry-based analyses. Methods: We evaluated patients in the Scientific Registry of Transplant Recipients who were relisted after renal graft failure with new, unacceptable antigens corresponding to the HLA typing of their previous donor (UA-PD) as a proxy for donor-specific antibodies. Linear regression was applied to estimate the effects of HLA mismatches on UA-PD and the effects of UA-PD on calculated panel reactive antibody (cPRA) values for 4867 kidney recipients from 2010 to 2021. Results: Each additional HLA-DQ mismatch increased the probability of UA-PD by 25.2% among deceased donor transplant recipients and by 28.9% among living donor transplant recipients, significantly more than all other HLA loci ( Conclusions: HLA-DQ mismatches had the strongest associations with UA-PD, an effect that was greatest in African American and Hispanic recipients. cPRA increases with HLA-DQ UA-PD were equivalent or larger than any other HLA locus. This suggests a need to consider the effects of HLA-DQ in kidney allocation. |
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| MeSH term(s) | Humans ; Transplants ; Transplant Recipients ; Antibodies ; Living Donors ; HLA-DQ Antigens/genetics | |||||
| Chemical Substances | Antibodies ; HLA-DQ Antigens | |||||
| Language | English | |||||
| Publishing date | 2022-08-31 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article ; Research Support, Non-U.S. Gov't | |||||
| ZDB-ID | 1085942-1 | |||||
| ISSN | 1533-3450 ; 1046-6673 | |||||
| ISSN (online) | 1533-3450 | |||||
| ISSN | 1046-6673 | |||||
| DOI | 10.1681/ASN.2022030296 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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