Kidney transplant outcomes in patients with antibodies to human neutrophil antigen 3a

• Published in: Transplant immunology 2023-12, Vol.81, p.101905-101905, Article 101905
• Main Authors: Cannon, Emma, Stevenson, Karen, Little, Ann-Margaret, McKenzie, David, Hastie, Catherine, Calvert, Anthony, Poles, Anthony, Battle, Richard, McConnell, Sylvia, Phelan, Paul J, Turner, David
• Format: Article
• Language: English
• Subjects: Autoantibodies; Female; Graft Rejection; Graft Survival; HLA Antigens; Humans; Isoantibodies; Kidney Transplantation - adverse effects; Living Donors; Male; Neutrophils; Pregnancy; Retrospective Studies
• ISSN: 0966-3274; 1878-5492
• DOI: 10.1016/j.trim.2023.101905

Antibody mediated rejection (ABMR) of kidney transplants has been shown to occur in the absence of a known donor specific antibody to human leucocyte antigen (HLA). Antibodies to the human neutrophil antigen (HNA) system have been detected in kidney transplant recipients and linked to ABMR in the absence of an HLA donor specific antibody (DSA), but there remains limited literature regarding this. Case series analysis was carried out examining three cases of HNA-3a antibody positive flow cytometry cross match (FC-XM) from two transplant centres in Scotland. All patients included were female and had been sensitised as a result of pregnancy. One live donor recipient with HNA-3a antibodies identified prior to transplant received ATG induction and has had a good outcome. The remaining two patients received deceased donor transplants. HNA-3a antibodies were indicated following a retrospective flow cytometry crossmatch. Both patients received Basiliximab induction and both have experienced ABMR requiring supplementary immunosuppression. The predicted rate of HNA-3a antibodies amongst patients awaiting kidney transplant in the UK is