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Submitted: 02 Feb 2022
Accepted: 23 Apr 2022
ePublished: 06 May 2022
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J Renal Inj Prev. 2022;11(2): e32063.
doi: 10.34172/jrip.2022.32063

Scopus ID: 85130324549
  Abstract View: 1639
  PDF Download: 1100

Original

Prevalence of anti-HLA antibodies in highly sensitized kidney transplant candidates

Farahnooh Farnood 1 ORCID logo, Alireza Mardomi 1 ORCID logo, Sepide Zununi Vahed 1 ORCID logo, Mohammadreza Ardalan 1* ORCID logo

1 Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
*Corresponding Author: *Corresponding authors: Prof. Mohammadreza Ardalan, Email: ardalan34@yahoo.com, , Email: ardalanm@tbzmed.ac.ir

Abstract

Introduction: Kidney transplantation is the standard gold therapy for the treatment of the majority of end-stage renal diseases (ESRDs). Despite the general success rate of allogeneic transplantation due to immunosuppressive therapy, it is difficult to find an appropriate donor for some sensitized patients.

Objectives: This study aimed to estimate the prevalence and titers of anti-HLA-class I and anti-HLA-class II antibodies in sensitized patients in a kidney transplantation center. The history of the risk factors of sensitization was studied.

Patients and Methods: Twenty highly sensitized ESRD patients with a calculated panel-reactive antibody (CPRA) ≥50% were selected, and anti-HLA-I and anti-HLA-II antibodies were assessed in their sera using a single antigen bead (SAB) Luminex assay.

Results: The previous history of kidney transplantation was the most critical sensitization risk factor. The results indicated that HLA A*24:02 and DQA1*02:01/DQB1*06:02 were the most frequent antibodies in class I and class II, respectively. Moreover, the mean fluorescence intensity (MFI) levels of anti-HLA class II antibodies were significantly higher than the MFI levels of anti-HLA class I antibodies.

Conclusion: According to the findings of this study, matching HLA alleles, particularly class II molecules, can reduce sensitization in the first kidney transplant. A better understanding of the sensitization status of transplant candidates could be gained by examining CPRA values.


Implication for health policy/practice/research/medical education:

The presence of pre-existing donor-specific anti-HLA antibody (DSA) increases the risk of hyperacute allograft rejection. The present study evaluated the anti-HLA-class I and anti-HLA-class II antibodies and defined the common causes of sensitization among renal transplantation candidates. The results indicated that the previous history of kidney transplantation was the most prevalent cause of sensitization. Besides, the proper matching of some HLA loci, HLA DRB1, and HLA DQBI was more important in the prophylaxis against the formation of a broad spectrum of anti-HLA antibodies and the establishment of sensitization.

Please cite this paper as: Farnood F, Mardomi A, Zununi Vahed S, Ardalan M. Prevalence of anti-HLA antibodies in highly sensitized kidney transplant candidates. J Renal Inj Prev. 2022; 11(2): 32063. doi: 10.34172/jrip.2022.32063.

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