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Artikel ; Online: HLA-DQ Mismatches Lead to More Unacceptable Antigens, Greater Sensitization, and Increased Disparities in Repeat Transplant Candidates.

Isaacson, Dylan / Schold, Jesse D / Gmeiner, Michael W / Copley, Hannah C / Kosmoliaptsis, Vasilis / Tambur, Anat R

Journal of the American Society of Nephrology : JASN

2022  Band 33, Heft 12, Seite(n) 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.
Mesh-Begriff(e) Humans ; Transplants ; Transplant Recipients ; Antibodies ; Living Donors ; HLA-DQ Antigens/genetics
Chemische Substanzen Antibodies ; HLA-DQ Antigens
Sprache Englisch
Erscheinungsdatum 2022-08-31
Erscheinungsland United States
Dokumenttyp 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
Signatur
Zs.A 3344: Hefte anzeigen Standort:
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