title: Clinical relevance of pre- and post-transplant HLA antibodies, donor-specific, and nondonor-specific HLA antibodies detected by ELISA in renal transplantation.
abstract: Human leukocyte antigen (HLA) antibodies reactive to donor antigens (DSA) and non-donor specific antigens (NDSA) were detected by enzyme-linked immunosorbent assay (ELISA) to determine their impact on long-term graft survival. Among 162 patients who had no pre-transplant HLA antibodies, 5-year graft survival was 87%. There was a significant difference compared with 72% for 18 patients who had pre-transplant HLA antibodies (p=0.031). There was a significant difference in graft survival between patients with pre-transplant NDSA and those without HLA antibodies (p=0.0005), but there was not between patients with pre-transplant DSA and those without HLA antibodies (p=0.615). Among 148 patients who had no post-transplant HLA antibodies, 5-year graft survival was 86%. There was no significant difference compared with 85% for 32 patients who had post-transplant HLA antibodies (p=0.118). There was a significant difference in graft survival between patients with post-transplant DSA and those without HLA antibodies (p=0.006), but there was not between patients with post-transplant NDSA and those without HLA antibodies (p=0.599). In conclusion, pre-transplant NDSA and post-transplant DSA were associated with poor long-term graft survival. For patients who had persistent pre- and post-transplant HLA antibodies, the worst long-term survival could be found. We believe HLA antibody analysis by ELISA is still very useful for transplantation.
authors.forename: Po-Chang
authors.initials: PC
authors.lastname: Lee
authors.forename: Yi Lin
authors.initials: YL
authors.lastname: Chen
authors.forename: Wei-Ming
authors.initials: WM
authors.lastname: Wang
authors.forename: Wan Chi
authors.initials: WC
authors.lastname: Tu
authors.forename: Hsuan Yu
authors.initials: HY
authors.lastname: Chen
mesh_terms: D000328:Adult; D000918:Antibody Specificity; D001323:Autoantibodies / Q000097:blood / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006084:Graft Rejection / Q000276:immunology* / Q000401:mortality*; D006085:Graft Survival / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D007518:Isoantibodies / Q000097:blood / Q000276:immunology; D016030:Kidney Transplantation / Q000401:mortality* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011237:Predictive Value of Tests; D057234:Preoperative Period; D016036:Seroepidemiologic Studies; D014019:Tissue Donors
chemical_list: D001323:Autoantibodies; D006680:HLA Antigens; D007518:Isoantibodies