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fimmu-13-924825.pdf (1.27 MB)

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2022-09-29

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cc by (c) Meneghini, Maria et al., 2022
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/190743

On the clinical relevance of using complete high-resolution HLA typing for an accurate interpretation of posttransplant immune-mediated graft outcomes

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https://doi.org/10.3389/fimmu.2022.924825

Resum

Complete and high-resolution (HR) HLA typing improves the accurate assessment of donor-recipient compatibility and pre-transplant donor-specific antibodies (DSA). However, the value of this information to identify de novo immune-mediated graft events and its impact on outcomes has not been assessed. In 241 donor/recipient kidney transplant pairs, DNA samples were re-evaluated for six-locus (A/B/C/DRB1/DQB1+A1/DPB1) HR HLA typing. De novo anti-HLA antibodies were assessed using solid-phase assays, and dnDSA were classified either (1) as per current clinical practice according to three-locus (A/B/DRB1) low-resolution (LR) typing, estimating donor HLA-C/DQ typing with frequency tables, or (2) according to complete six-locus HR typing. The impact on graft outcomes was compared between groups. According to LR HLA typing, 36 (15%) patients developed dnDSA (LR_dnDSA+). Twenty-nine out of 36 (80%) were confirmed to have dnDSA by HR typing (LR_dnDSA+/HR_dnDSA+), whereas 7 (20%) did not (LR_dnDSA+/HR_dnDSA-). Out of 49 LR_dnDSA specificities, 34 (69%) were confirmed by HR typing whereas 15 (31%) LR specificities were not confirmed. LR_dnDSA+/HR_dnDSA+ patients were at higher risk of ABMR as compared to dnDSA- and LR_dnDSA+/HR_dnDSA- (logRank < 0.001), and higher risk of death-censored graft loss (logRank = 0.001). Both LR_dnDSA+ (HR: 3.51, 95% CI = 1.25-9.85) and LR_dnDSA+/HR_dnDSA+ (HR: 4.09, 95% CI = 1.45-11.54), but not LR_dnDSA+/HR_dnDSA- independently predicted graft loss. The implementation of HR HLA typing improves the characterization of biologically relevant de novo anti-HLA DSA and discriminates patients with poorer graft outcomes.

Matèries

Trasplantament renal, Rebuig (Biologia)

Matèries (anglès)

Kidney transplantation, Graft rejection

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Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

Citació

MENEGHINI, Maria, PERONA, Anna, CRESPO FERNÁNDEZ, Elena, BEMELMAN, Frederike, REINKE, Petra, VIKLICKY, Ondrej, GIRAL, Magali, PALOU, Eduard, TORIJA RECASENS, Alba, DONADEU, Laura, MELILLI, Edoardo, ZUÑIGA, Jose, SEFRIN, Anett, LACHMANN, Nils, HU, Liu, HRUBA, Petra, GUILLOT GUEGUEN, Cécile, BROUARD, Sophie, GRINYÓ BOIRA, Josep m., BESTARD MATAMOROS, Oriol. On the clinical relevance of using complete high-resolution HLA typing for an accurate interpretation of posttransplant immune-mediated graft outcomes. _Frontiers in Immunology_. 2022. Vol. 13. [consulta: 21 de gener de 2026]. ISSN: 1664-3224. [Disponible a: https://hdl.handle.net/2445/190743]

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