HLA class I residue mismatch and renal graft outcome.
Donor-recipient HLA matching was retrospectively evaluated in 111 cadaveric renal transplants using Takemoto's ten-residue model in which HLA class I antigens are clustered by crossreactive group (CREGs) on the basis of amino acid sequence homology and the sharing of a particular public epitope. The grade and type of HLA residue mismatching were correlated to posttransplant, class I donor-specific antibody production (monitored by flow cytometry crossmatch), rejection occurrence and clinical outcome during the 1st year posttransplant. In 52 patients with 0 mismatchings (MMs) we observed a low incidence of rejection (11.1%) and antibody production (11.1%) for 0 CREG MM grade, while 1 MM was enough to increase immune response against graft (rejection 35%; antibodies 30%). Moreover, a significant correlation was observed between Q144, E163, Q62 and L82/R82 epitopes and the incidence of acute rejection and antibody production ("immunogenic" residues) in patients grouped for a single residue mismatch.
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Istituto CNR Tipizzazione Tissutale e Problemi della Dialisi, L'Aquila, Italy.
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D000917:Antibody Formation; D002102:Cadaver; D000939:Epitopes / Q000737:chemistry / Q000276:immunology*; D006084:Graft Rejection / Q000453:epidemiology / Q000276:immunology; D006085:Graft Survival; D015395:Histocompatibility Antigens Class I / Q000737:chemistry / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D016030:Kidney Transplantation / Q000276:immunology / Q000502:physiology*; D012189:Retrospective Studies; D014019:Tissue Donors; D016896:Treatment Outcome
D000939:Epitopes; D015395:Histocompatibility Antigens Class I; D007074:Immunoglobulin G; D007075:Immunoglobulin M