title: Long-term follow-up of non-HLA and anti-HLA antibodies: incidence and importance in renal transplantation.
abstract: BACKGROUND
  Detection of antibody-mediated injury is becoming increasingly important in post-transplant patient care. The role of donor-specific anti-human leukocyte antigen (HLA) antibodies in kidney transplant damage is known, whereas the significance of non-HLA antibodies remains an unresolved concern. The aim of the study was to determine the presence and influence on renal function of non-HLA and anti-HLA antibodies in stable patients at 5 years after kidney transplantation.
  
  
  METHODS
  We evaluated the antibodies in 35 consecutive patients with stable renal function at 5 years after transplantation.
  
  
  RESULTS
  Pretransplant screening for donor-specific antibodies by CDC cross-matches was negative in all patients. Anti-endothelial cell antibodies (AECA), anti-angiotensin II type 1 receptor antibodies (anti-AT1R), and anti-endothelin receptor antibodies (anti-ETAR) were assayed as non-HLA antibodies. Non-HLA antibodies were observed in 12 (34%) patients, including AECA (n = 5; 14%), anti- AT1R (n = 6; 17%), anti-ETAR (n = 4; 11%), and both anti-AT1R and anti-ETAR (n = 3). Among 13 (37%) patients with anti-HLA antibodies, 7 also had both non-HLA antibodies: AECA (n = 1), anti-AT1R (n = 3), and anti-ETAR (n = 3). The antibody-negative group (n = 13) showed significantly better renal function than the antibody-positive group (non-HLA and/or anti-HLA; n = 22). Biopsy-proven acute rejection had occurred in 2 of 13 (15%) antibody-negative versus 8 of 22 (36%) antibody-positive patients. These preliminary data revealed an high prevalence of autoantibody and alloantibody production among stable patients at 5 years after kidney transplantation.
  
  
  CONCLUSIONS
  Simultaneous production of these antibodies and their association with reduced renal function suggests that active humoral immune responses are poorly controlled by immunosuppression.
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wrocław Medical University, Wrocław, Poland. m.banasik@interia.pl
authors.forename: M
authors.initials: M
authors.lastname: Banasik
authors.forename: M
authors.initials: M
authors.lastname: Boratyńska
authors.forename: K
authors.initials: K
authors.lastname: Kościelska-Kasprzak
authors.forename: O
authors.initials: O
authors.lastname: Mazanowska
authors.forename: D
authors.initials: D
authors.lastname: Bartoszek
authors.forename: M
authors.initials: M
authors.lastname: Zabińska
authors.forename: M
authors.initials: M
authors.lastname: Myszka
authors.forename: B
authors.initials: B
authors.lastname: Nowakowska
authors.forename: A
authors.initials: A
authors.lastname: Hałoń
authors.forename: P
authors.initials: P
authors.lastname: Szyber
authors.forename: D
authors.initials: D
authors.lastname: Patrzałek
authors.forename: M
authors.initials: M
authors.lastname: Klinger
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged
chemical_list: D001323:Autoantibodies; D006680:HLA Antigens