Anti‐HLA alloantibodies of the IgA isotype in re‐transplant candidates part II: Correlation with graft survival |
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| Authors: | M‐L Arnold C Bach F M Heinemann P A Horn M Ziemann N Lachmann A Mühlbacher A Dick A Ender D Thammanichanond S Schaub G Hönger G F Fischer J Mytilineos M Hallensleben W E Hitzler C Seidl B M Spriewald |
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| Institution: | 1. Department of Internal Medicine 3 ‐ Rheumatology and Immunology, Friedrich‐Alexander‐University Erlangen‐Nürnberg (FAU), Universit?tsklinikum Erlangen, Erlangen, Germany;2. Department of Internal Medicine 5 ‐ Hematology and Oncology, Friedrich‐Alexander‐University Erlangen‐Nürnberg (FAU), Universit?tsklinikum Erlangen, Erlangen, Germany;3. Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany;4. Institute of Transfusion Medicine, University Hospital of Schleswig‐Holstein, Lübeck‐ Kiel, Germany;5. HLA Laboratory, Center for Tumor Medicine, Charité, Berlin, Germany;6. Central Institute for Blood Transfusion and Immunology, General Hospital and University Clinics, Innsbruck, Austria;7. Laboratory for Immunogenetics, University Hospital Grosshadern, Ludwig‐Maximilians‐University, Munich, Germany;8. Central Institute for Transfusion Medicine and Blood Donation, Katharinenhospital Stuttgart, Stuttgart, Germany;9. Histocompatibility and Immunogenetics Laboratory, Department of Pathology, Mahidol University Bangkok, Bangkok, Thailand;10. HLA‐Diagnostics and Immunogenetics, Department of Laboratory Medicine, Transplantation Immunology & Nephrology, Department of Biomedicine, University Hospital Basel, Basel, Switzerland;11. Transplantation Immunology and Nephrology, Department of Biomedicine, University Basel, Basel, Switzerland;12. Department for Blood Group Serology and Transfusion Medicine, Medical University Vienna, Vienna, Austria;13. Institute of Clinical Transfusion Medicine and Immunogenetics, University Hospital of Ulm, Ulm, Germany;14. Institute for Transfusion Medicine, Hannover Medical School, Hannover, Germany;15. Transfusion Center, University Medical Center, Johannes Gutenberg‐University Mainz, Mainz, Germany;16. German Red Cross Blood Donor Service, Institute for Transfusion Medicine and Immunohaematology, Frankfurt, Germany |
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| Abstract: | We reported previously on the widespread occurrence of anti‐HLA alloantibodies of the IgA isotype (anti‐HLA IgA) in the sera of solid‐organ re‐transplantation (re‐tx) candidates (Arnold et al., 2013 ). Specifically focussing on kidney re‐tx patients, we now extended our earlier findings by examining the impact of the presence and donor specificity of anti‐HLA IgA on graft survival. We observed frequent concurrence of anti‐HLA IgA and anti‐HLA IgG in 27% of our multicenter collective of 694 kidney re‐tx patients. This subgroup displayed significantly reduced graft survival as evidenced by the median time to first dialysis after transplantation (TTD 77 months) compared to patients carrying either anti‐HLA IgG or IgA (TTD 102 and 94 months, respectively). In addition, donor specificity of anti‐HLA IgA had a significant negative impact on graft survival (TTD 74 months) in our study. Taken together, our data strongly indicate that presence of anti‐HLA IgA, in particular in conjunction with anti‐HLA‐IgG, in sera of kidney re‐tx patients is associated with negative transplantation outcome. |
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| Keywords: | antibodies graft rejection graft survival histocompatibility testing immunoglobulin isotypes transplantation |
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