title: Assessment of differences in HLA-A, -B, and -DRB1 allele mismatches among African-American and non-African-American recipients of deceased kidney transplants.
abstract: Among recipients of deceased donor kidney transplants, African-Americans experience a more rapid rate of kidney allograft loss than non-African-Americans. The purpose of this study was to characterize and quantify the HLA-A, -B, and -DRB1 allele mismatches and amino acid substitutions at antigen recognition sites among African-American and non-African-American recipients of deceased donor kidney transplants matched at the antigen level. In recipients with zero HLA antigen mismatches, the degree of one or two HLA allele mismatches for both racial groups combined was 47%, 29%, and 11% at HLA-DRB1, HLA-B, and HLA-A, respectively. There was a greater number of allele mismatches in African-Americans than non-African-Americans at HLA-A (P < .0001), -B (P = .096), and -DRB1 loci (P < .0001). For both racial groups, the HLA allele mismatches were predominantly at A2 for HLA-A; B35 and B44 for HLA-B; but multiple specificities for HLA-DRB1. The observed amino acid mismatches were concentrated at a few functional positions in the antigen binding site of HLA-A and -B and -DRB1 molecules. Future studies are ongoing to assess the impact of these HLA mismatches on kidney allograft loss.
authors.affiliation: Department of Pathology and Laboratory Medicine, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
authors.forename: M
authors.initials: M
authors.lastname: Kamoun
authors.forename: A K
authors.initials: AK
authors.lastname: Israni
authors.forename: M M
authors.initials: MM
authors.lastname: Joffe
authors.forename: T
authors.initials: T
authors.lastname: Hoy
authors.forename: J
authors.initials: J
authors.lastname: Kearns
authors.forename: K C
authors.initials: KC
authors.lastname: Mange
authors.forename: D
authors.initials: D
authors.lastname: Feldman
authors.forename: N
authors.initials: N
authors.lastname: Goodman
authors.forename: S E
authors.initials: SE
authors.lastname: Rosas
authors.forename: J D
authors.initials: JD
authors.lastname: Abrams
authors.forename: K L
authors.initials: KL
authors.lastname: Brayman
authors.forename: H I
authors.initials: HI
authors.lastname: Feldman
mesh_terms: D019943:Amino Acid Substitution; D044383:Black People / Q000235:genetics; D002102:Cadaver; D002423:Cause of Death; D004247:DNA / Q000235:genetics / Q000302:isolation & purification; D015234:HLA-A Antigens / Q000235:genetics*; D015235:HLA-B Antigens / Q000235:genetics*; D006684:HLA-DR Antigens / Q000235:genetics*; D059811:HLA-DRB1 Chains; D006650:Histocompatibility Testing; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000276:immunology*; D011446:Prospective Studies; D014019:Tissue Donors; D014184:Transplantation, Homologous; D014481:United States; D044465:White People / Q000235:genetics; D001741:Black or African American
chemical_list: D015234:HLA-A Antigens; D015235:HLA-B Antigens; D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains; D004247:DNA