Effects of different sensitization events on HLA alloimmunization in renal transplant cases; a retrospective observation in 1066 cases |
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| Institution: | 1. Department of Transfusion Medicine, Histocompatibility and Molecular Biology, Jaypee Hospital, Noida, UP 201301, India;2. Department of Histocompatibility and Molecular Biology, Jaypee Hospital, Noida, UP 201301, India;3. Department of Transfusion Medicine, Jaypee Hospital, Noida, UP 201301, India;4. Department of Urology and kidney transplant, Jaypee Hospital, Noida, UP 201301, India;5. Department of Nephrology and kidney transplant, Jaypee Hospital, Noida, UP 201301, India;1. Department of Nephrology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India;2. Department of Urology Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India;1. Fédération des Spécialités Digestives, Hôpital Edouard Herriot, Hospices civils de Lyon, Lyon, France;2. Université Claude Bernard Lyon 1, Lyon, France;3. Service d''hépatologie et de Transplantation Hépatique, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France;4. Service des Maladies de l''Appareil Digestif, Hôpital Claude Huriez, CHRU Lille, Lille, France;5. Centre Hépato-Biliaire, Hôpital Paul Brousse, AP-HP, Villejuif, France;6. Département de Néphrologie et Transplantation d''Organes, CHU Rangueil, Toulouse, France;1. Department of Neurology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250031, China;2. Department of Psychology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250031, China;3. Department of Neurology, Shandong Provincial Third Hospital, Shandong University, Jinan, Shandong 250031, China;1. Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, USA;2. Starzl Transplantation Institute, Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA;3. Division of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, ZH, Switzerland;4. th;5. Department of Surgery, Uniformed Service University of the Health Sciences, Bethesda, MD, USA;6. Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA;7. Wake Forest Institute for Regenerative Medicine, Wake Forest University, Winston-Salem, NC, USA;8. Division of Plastic Surgery, Department of Surgery, University of Colorado, Denver, CO, USA;9. Department of Immunology, University of Pittsburgh, Pittsburgh, PA, USA;1. Department of Oncology, The First Hospital, Jilin University, Changchun 130021, China;2. Key Laboratory of Organ Regeneration & Transplantation of the Ministry of Education, The First Hospital, Jilin University; Changchun, 130061, China;3. National-Local Joint Engineering Laboratory of Animal Models for Human Diseases, Changchun 130061, China;4. Department of Hematology, The First Hospital, Jilin University, Changchun 130021, China;1. Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Sindh, Pakistan;2. Shifa College of Medicine, Islamabad, Pakistan;3. Kabir Medical College, Gandhara University, Peshawar, Pakistan;4. Institute of Public Health and Social Science (IPH&SS), Khyber Medical University, Peshawar, Pakistan;5. Mehboob School of Physiotherapy, Hayatabad, Peshawar, Pakistan;6. Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden |
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| Abstract: | BackgroundPatients awaiting solid organ transplantation may develop anti-HLA antibodies after sensitization events such as transfusions, pregnancies, or previous transplantations. However, the effects of a particular sensitization event on HLA alloimmunization have not been well studied in parallel using cell-based assays and solid-phase assays. In this study, we evaluated and compare how different sensitization events affect the HLA antibody screening (HLA-Ab) and donor specific antibody (DSA) status in solid renal organ transplantation patients.MethodsHLA antibody (HLA-Ab) screening tests like complement-dependent cytotoxicity crossmatch (CDC-XM), flow cytometry crossmatch (FC-XM) and Luminex panel-reactive antibody (L-PRA) were performed in all 1066 patients (635 males and 431 females). If any of these tests turned out to be positive, a Luminex single antigen bead (L-SAB) assay was performed for DSA identification. Test positive rates and antibody strengths were analyzed according to the different sensitization events and gender.ResultsIn this study, HLA-Ab screening tests positive rates (L-PRA, FC-XM and CDC-XM) were significantly higher in patients with previous transplantation (73.91%, 100% and 56.52% p < 0.001), previous pregnancy (57.46%, 70.14% and 18.85% p < 0.001) or blood transfusion (27.33%, 35.55% and 7.33% p < 0.001) compared with patients without a sensitizing event (6.17%, 13.58% and 1.09). In this study, re-transplantation group showed significantly stronger antibody strength (DSA) than non sensitized group (class I and II MFI 11418.04, 17,837.78 vs class I and II MFI 2659, 3329; P < 0.001) and those with single sensitization events of transfusion (class I and II MFI 11418.04, 17,837.78 vs class I and II MFI 5790.26, 6004.16; P < 0.001) or pregnancy (class I & II MFI 11418, 17,837 vs class I and II MFI 8631.71, 7253.29; P < 0.001).ConclusionsPregnancy and blood transfused had high allo-immunization rate for class I HLA antigens. While re-transplantation patients had high allo-immunization rate for both the HLA classes (HLA- class I and HLA- class II). Re-transplantation group showed significantly stronger antibody strength, followed by pregnancy and then transfusion. |
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