Human leukocyte antigen mismatch and circulating donor-specific antibodies predict graft loss after kidney transplantation: A retrospective study from Campania region - Italy.

Autor: Strozziero M; U.O.C. Division of Clinical Immunology, Immunohematology, Transfusion Medicine, and Transplant Immunology. Regional Reference Laboratory of Transplant Immunology (LIT), Department of Internal Medicine, Geriatry and Neurology, University of Campania 'L. Vanvitelli', Naples, Italy; IRCCS Synlab SDN, Naples, Italy., Costa D; U.O.C. Division of Clinical Immunology, Immunohematology, Transfusion Medicine, and Transplant Immunology. Regional Reference Laboratory of Transplant Immunology (LIT), Department of Internal Medicine, Geriatry and Neurology, University of Campania 'L. Vanvitelli', Naples, Italy. Electronic address: dario.costa@policliniconapoli.it., Benincasa G; U.O.C. Division of Clinical Immunology, Immunohematology, Transfusion Medicine, and Transplant Immunology. Regional Reference Laboratory of Transplant Immunology (LIT), Department of Internal Medicine, Geriatry and Neurology, University of Campania 'L. Vanvitelli', Naples, Italy; Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania 'Luigi Vanvitelli', Naples, Italy., Grimaldi V; U.O.C. Division of Clinical Immunology, Immunohematology, Transfusion Medicine, and Transplant Immunology. Regional Reference Laboratory of Transplant Immunology (LIT), Department of Internal Medicine, Geriatry and Neurology, University of Campania 'L. Vanvitelli', Naples, Italy., De Rosa P; General Surgery and Transplantation Unit, 'San Giovanni di Dio e Ruggi D'Aragona', University Hospital, Scuola Medica Salernitana, Salerno, Italy., Valeriani G; General Surgery and Transplantation Unit, 'San Giovanni di Dio e Ruggi D'Aragona', University Hospital, Scuola Medica Salernitana, Salerno, Italy., Santangelo M; Department of Public Health, Section of Nephrology, University of Naples 'Federico II', Naples, Italy., Carrano R; Department of Public Health, Section of Nephrology, University of Naples 'Federico II', Naples, Italy., Pacilio S; Department of Translational Medical Sciences, University of Naples 'Federico II', Naples, Italy., Cacciatore F; Department of Translational Medical Sciences, University of Naples 'Federico II', Naples, Italy. Electronic address: francesco.cacciatore@unina.it., Napoli C; U.O.C. Division of Clinical Immunology, Immunohematology, Transfusion Medicine, and Transplant Immunology. Regional Reference Laboratory of Transplant Immunology (LIT), Department of Internal Medicine, Geriatry and Neurology, University of Campania 'L. Vanvitelli', Naples, Italy.
Jazyk: angličtina
Zdroj: Human immunology [Hum Immunol] 2024 Nov; Vol. 85 (6), pp. 111166. Date of Electronic Publication: 2024 Nov 05.
DOI: 10.1016/j.humimm.2024.111166
Abstrakt: Donor-specific antibodies (DSA) are an established biomarker predicting antibody-mediated rejection, as the leading cause of graft loss after kidney transplantation. Furthermore, human leukocyte antigen (HLA) matching offers a more precise assessment of donor-recipient HLA compatibility and may prevent more effectively sensitization against allograft tissue. Indeed, increased number of HLA mismatches (MM) is significantly associated with a higher risk of immunological rejection, de novo DSA (dnDSA) development, and graft failure. Over the last decade, a comprehensive approach to optimize kidney matching and monitor transplant recipients for acute and chronic graft dysfunction was the goal for the success of the kidney transplantation. In our long-term retrospective study, we have found that pre- and post-transplantation HLA antibodies were significantly associated with de novo dnDSA occurrence (pre-transplant HLA Class I antibodies p = 0.039p < 0.05; pre-transplant HLA Class II antibodies p = 0.011p < 0.05; post-transplant HLA Class I non-DSA antibodies p < 0.01; post-transplant HLA Class II non-DSA antibodies p < 0.01). In addition, HLA MM at locus A (hazard ratio (HR), 2.44; 95 % confidence interval (CI): 1.15-5.16; p = 0.01 hazard ratio (HR), 2.33; 95 % confidence interval (CI):1.132-4.805; p = 0.02) and DSA Class I (HR, 10.24; 95 % CI: 1.44-72.62; p = 0.02 HR, 5.539; 95 % CI: 1.264-24.272; p = 0.02) appeared to be significant predictors of poorer graft survival. Our investigation demonstrates the long medium-term experience of DSA development occurrence in patients with after kidney transplantation in Campania region - Italy.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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