HLA antigens and post renal transplant lymphoproliferative disease: HLA-B matching is critical.
Although several risk factors for posttransplant lymphoproliferative disease (PTLD) after solid organ transplantation have been identified, the immunosuppressive regimen probably as most important one, their exact pathogenic role and relevance is still unclear. In hematopoietic stem cell transplantation, HLA mismatching also is a risk factor. We analyzed factors possibly associated with development of PTLD in patients receiving a kidney transplant at our hospital between 1985 and 2002. PTLD was observed in 20 out of 1,013 patients (2.0%). Mismatches at the HLA-B locus, but not at the HLA-A or HLA-DR loci, and anti T-cell antibody therapy were both independently associated with development of PTLD. Hazard ratios increased from 1.4 (0.5-4.1) with one mismatch to 5.1 (1.4-19.0) in case of two HLA-B mismatches. Decreased surveillance by T-cells with dual specificity for Epstein-Barr virus (EBV) as well as for allo HLA antigens on the allograft might facilitate clonal expansion of B-cells latently infected with EBV.
Bakker
Nicolaas A
NA
Department of Hematology, University Medical Center Groningen, The Netherlands.
van Imhoff
Gustaaf W
GW
Verschuuren
Erik A M
EA
van Son
Willem J
WJ
van der Heide
Jaap J Homan
JJ
Lems
Simon P M
SP
Veeger
Nic J G M
NJ
Kluin
Philip M
PM
Kluin-Nelemans
Hanneke C
HC
Hepkema
Bouke G
BG
D000293:Adolescent; D000328:Adult; D000368:Aged; D020031:Epstein-Barr Virus Infections / Q000453:epidemiology / Q000276:immunology; D005260:Female; D015234:HLA-A Antigens / Q000276:immunology; D015235:HLA-B Antigens / Q000276:immunology*; D006684:HLA-DR Antigens / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology* / Q000706:statistics & numerical data*; D008232:Lymphoproliferative Disorders / Q000453:epidemiology* / Q000276:immunology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology / Q000276:immunology; D012307:Risk Factors
D015234:HLA-A Antigens; D015235:HLA-B Antigens; D006684:HLA-DR Antigens