Deleterious impact of mismatching for human leukocyte antigen-C in presensitized recipients of kidney transplants

BACKGROUND: Allocation of deceased donor kidneys is commonly based on matching for human leukocyte antigen (HLA)-A, -B, and -DR, whereas HLA-C is currently disregarded. We investigated the influence of HLA-C compatibility on renal allograft survival. In addition, we tested an approach of matching fo...

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Main Authors: Tran, Thuong Hien (Author) , Döhler, Bernd (Author) , Heinold, Andreas (Author) , Scherer, Sabine (Author) , Ruhenstroth, Andrea (Author) , Opelz, Gerhard (Author)
Format: Article (Journal)
Language:English
Published: 2011
In: Transplantation
Year: 2011, Volume: 92, Issue: 4, Pages: 419-425
ISSN:1534-6080
DOI:10.1097/TP.0b013e318224c14e
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1097/TP.0b013e318224c14e
Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/transplantjournal/Fulltext/2011/08270/Deleterious_Impact_of_Mismatching_for_Human.7.aspx
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Author Notes:Thuong Hien Tran, Bernd Döhler, Andreas Heinold, Sabine Scherer, Andrea Ruhenstroth, and Gerhard Opelz
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Summary:BACKGROUND: Allocation of deceased donor kidneys is commonly based on matching for human leukocyte antigen (HLA)-A, -B, and -DR, whereas HLA-C is currently disregarded. We investigated the influence of HLA-C compatibility on renal allograft survival. In addition, we tested an approach of matching for HLA-C epitopes. METHODS: A cohort of 2260 deceased donor kidney transplants were typed for HLA-C using polymerase chain reaction-sequence specific primer method. Samples for DNA typing, serum results on presensitization (lymphocytotoxicity), and clinical data were provided by transplant centers participating in the Collaborative Transplant Study. RESULTS: HLA-C mismatch was found to be associated with significantly decreased graft survival in presensitized (P<0.001) but not in non-presensitized (P=0.75) recipients. Mismatch of certain HLA-C epitopes seemed to be more influential than others, with mismatches showing a negative impact on graft survival in presensitized patients. CONCLUSIONS: HLA-C mismatch has a substantial deleterious effect on graft survival in presensitized kidney recipients. Our study points out the need for investigations directed at identifying donor-specific HLA-C antibodies and evaluating their relevance in transplantation. In view of the fact that current assays for determining HLA-C specific antibodies are hampered by additional detection of clinically irrelevant antibodies, matching for HLA-C may provide a reasonable approach to improve transplant outcomes in presensitized kidney transplant recipients.
Item Description:Gesehen am 02.06.2021
Physical Description:Online Resource
ISSN:1534-6080
DOI:10.1097/TP.0b013e318224c14e