title: The number of amino acid triplet differences between patient and donor is predictive for the antibody reactivity against mismatched human leukocyte antigens.
abstract: BACKGROUND
  The correlation between antibody production against mismatched donor human leukocyte antigens (HLA) and the number of amino acid sequence mismatches was analyzed in patients who rejected a kidney transplant (n=146).
  
  
  METHODS
  A similar analysis was performed for the antibody production of women against the paternal HLA antigens of their child (n=1,397). The amino acid sequence (triplet) differences were analyzed using the HLAMatchmaker algorithm.
  
  
  RESULTS
  In both groups, a positive correlation was found between the number of triplet mismatches and the percentage of individuals producing antibodies (P <0.0001). If zero triplet mismatches were present, no antibodies were formed in all cases. When 11 or 12 triplet mismatches were present, 94% of the transplant patients produced antibodies against the donor. In pregnancy, 11 or 12 triplet mismatches led to 27% of the women producing specific antibodies.
  
  
  CONCLUSIONS
  These results indicate that the immunogenicity of the fetus is lower than that of a rejected kidney and that analysis of the number of triplet mismatches can predict the antibody reactivity against the mismatched HLA antigens.
authors.affiliation: Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands. m.k.a.dankers@lumc.nl
authors.forename: Marlies K A
authors.initials: MK
authors.lastname: Dankers
authors.forename: Marian D
authors.initials: MD
authors.lastname: Witvliet
authors.forename: Dave L
authors.initials: DL
authors.lastname: Roelen
authors.forename: Peter
authors.initials: P
authors.lastname: de Lange
authors.forename: Nelleke
authors.initials: N
authors.lastname: Korfage
authors.forename: Guido G
authors.initials: GG
authors.lastname: Persijn
authors.forename: René
authors.initials: R
authors.lastname: Duquesnoy
authors.forename: Ilias I N
authors.initials: II
authors.lastname: Doxiadis
authors.forename: Frans H J
authors.initials: FH
authors.lastname: Claas
mesh_terms: D000595:Amino Acid Sequence; D005260:Female; D006084:Graft Rejection / Q000235:genetics / Q000276:immunology; D006680:HLA Antigens / Q000235:genetics*; D006650:Histocompatibility Testing; D006801:Humans; D007518:Isoantibodies / Q000096:biosynthesis*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology*; D008297:Male; D008431:Maternal-Fetal Exchange / Q000235:genetics / Q000276:immunology; D011247:Pregnancy; D014019:Tissue Donors
chemical_list: D006680:HLA Antigens; D007518:Isoantibodies