title: Impact of HLA antibodies on transplant glomerulopathy.
abstract: The influence of humoral rejection on the development of chronic allograft nephropathy (CAN) is controversial, especially in relation to transplant glomerulopathy. The aim of our study was to analyse the influence of anti-HLA antibodies on the development of transplant glomerulopathy (cg0, cg1, cg2, and cg3; Banff'97). We selected all renal transplants patients from 1975 to 2003 who had a functioning graft for at least 6 months and a clinically indicated graft biopsy with CAN and chronic glomerular changes (case group). We studied the presence of anti-HLA antibodies (Ab) in the last serum taken while the graft was functioning and divided them into three groups according to the severity of glomerular lesions. We also selected 52 contemporary and comparable cases without transplant glomerulopathy (control group). A total of 77 case had transplant glomerulopathy: 39 cg1, 29 cg2, and 9 cg3. Pretransplant Ab titers and number of previous blood transfusions were higher among the subgroup with the most severe glomerulopathy. Patients who developed posttransplant anti-HLA Ab more frequently showed transplant glomerulopathy. Serum creatinine and proteinuria were higher among cases with chronic glomerulopathy, and more grafts were lost in that group. Thus, the presence of HLA-Ab is a key factor in the development of transplant glomerulopathy and chronic allograft rejection.
authors.affiliation: Department of Nephrology, Immunology, Department HUM Valdecilla, Santander, Spain. nefpfm@humv.es
authors.forename: R
authors.initials: R
authors.lastname: Palomar
authors.forename: M
authors.initials: M
authors.lastname: López-Hoyos
authors.forename: J M
authors.initials: JM
authors.lastname: Pastor
authors.forename: G
authors.initials: G
authors.lastname: Fernández-Fresnedo
authors.forename: E
authors.initials: E
authors.lastname: Rodrigo
authors.forename: J C
authors.initials: JC
authors.lastname: Ruiz
authors.forename: J G
authors.initials: JG
authors.lastname: Cotorruelo
authors.forename: R
authors.initials: R
authors.lastname: Valero
authors.forename: O
authors.initials: O
authors.lastname: Castañeda
authors.forename: D
authors.initials: D
authors.lastname: San Segundo
authors.forename: M
authors.initials: M
authors.lastname: Arias
mesh_terms: D005500:Follow-Up Studies; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D007678:Kidney Glomerulus / Q000473:pathology*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology / Q000473:pathology; D011183:Postoperative Complications / Q000276:immunology*; D012189:Retrospective Studies; D013997:Time Factors; D014184:Transplantation, Homologous
chemical_list: D006680:HLA Antigens; D007518:Isoantibodies