title: Impact of pretransplant human leukocyte antigen-C and -DP antibodies on kidney graft outcome.
abstract: The aim of our study was to determine whether the presence of specific human leukocyte antigen (HLA)-C and -DP antibodies before transplantation influenced graft outcomes in immunized recipients. Two groups of pretransplant immunized recipients were studied: patients with only classical HLA-A, -B, -DR, -DQ antibodies (n = 176) and those with classical plus HLA-C and/or -DP antibodies (n = 27). Acute antibody-mediated rejection was preferentially associated with the presence of pretransplant anti-HLA-C and -DP antibodies (5/6 cases). In four cases, acute rejection episodes were followed by graft loss within 15 months after transplantation. There was a significant increase in the number of acute rejection episodes especially antibody-mediated acute rejections (P = .036) and in the number of graft losses for immunologic reasons (P < .001) among the group with pretransplant anti-C and -DP antibodies. Pretransplant anti-DP antibodies seemed to be involved more frequently in poor graft outcomes as shown in several recent published cases. We need to investigate their specific role among a larger cohort, taking into account an epitope analysis.
authors.affiliation: Histocompatibility Laboratory, Etablissement Français du Sang Rhône-Alpes, Lyon, France.
authors.forename: M
authors.initials: M
authors.lastname: Gilbert
authors.forename: S
authors.initials: S
authors.lastname: Paul
authors.forename: G
authors.initials: G
authors.lastname: Perrat
authors.forename: C
authors.initials: C
authors.lastname: Giannoli
authors.forename: C
authors.initials: C
authors.lastname: Pouteil Noble
authors.forename: E
authors.initials: E
authors.lastname: Morelon
authors.forename: D
authors.initials: D
authors.lastname: Rigal
authors.forename: V
authors.initials: V
authors.lastname: Dubois
mesh_terms: D000906:Antibodies / Q000737:chemistry; D000939:Epitopes / Q000737:chemistry; D005434:Flow Cytometry / Q000379:methods; D006084:Graft Rejection; D006085:Graft Survival; D015236:HLA-C Antigens / Q000378:metabolism*; D006682:HLA-DP Antigens / Q000378:metabolism*; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic; D051437:Renal Insufficiency / Q000276:immunology* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000906:Antibodies; D000939:Epitopes; D015236:HLA-C Antigens; D006682:HLA-DP Antigens