The role of HLA-DP mismatches and donor specific HLA-DP antibodies in kidney transplantation: a case series

Background: The impact of HLA-DP mismatches on renal allograft outcome is still poorly understood and is suggested to be less than that of the other HLA loci. The common association of HLA-DP donor-specific antibodies (DSA) with other DSA obviates the evaluation of the actual effect of HLA-DP DSA. M...

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Published in:Transplant immunology 2021-04, Vol.65, p.101287-101287, Article 101287
Main Authors: Daniëls, Liesbeth, Claas, Frans H.J., Kramer, Cynthia S.M., Senev, Aleksandar, Vanden Driessche, Marleen, Emonds, Marie-Paule, Van Laecke, Steven, Hellemans, Rachel, Abramowicz, Daniel, Naesens, Maarten
Format: Article
Language:English
Subjects:
Crossmatch
Eplets
Graft Rejection
Histocompatibility Testing
HLA Antigens
HLA-DP antibodies
HLA-DP Antigens
Human leukocyte antigen
Humans
Isoantibodies
Kidney Transplantation
Renal transplantation
Retrospective Studies
Tissue Donors
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Summary:Background: The impact of HLA-DP mismatches on renal allograft outcome is still poorly understood and is suggested to be less than that of the other HLA loci. The common association of HLA-DP donor-specific antibodies (DSA) with other DSA obviates the evaluation of the actual effect of HLA-DP DSA. Methods: From a large multicenter data collection, we retrospectively evaluated the significance of HLA-DP DSA on transplant outcome and the immunogenicity of HLA-DP eplet mismatches with respect to the induction of HLA-DP DSA. Furthermore, we evaluated the association between the MFI of HLA-DP antibodies detected in Luminex assays and the outcome of flowcytometric/complement-dependent cytotoxicity (CDC) crossmatches. Results: In patients with isolated pretransplant HLA-DP antibodies (N = 13), 6 experienced antibody-mediated rejection (AMR) and 3 patients lost their graft. In HLAMatchmaker analysis of HLA-DP mismatches (N = 72), HLA-DP DSA developed after cessation of immunosuppression in all cases with 84DEAV (N = 14), in 86% of cases with 85GPM (N = 6/7), in 50% of cases with 56E (N = 6/12) and in 40% of cases with 56A mismatch (N = 2/5). Correlation analysis between isolated HLA-DP DSA MFI and crossmatches (N = 90) showed negative crossmatch results with HLA-DP DSA MFI
ISSN:0966-3274
1878-5492
DOI:10.1016/j.trim.2020.101287