TY - JOUR
T1 - DQ molecules are the principal stimulators of de novo donor-specific antibodies in nonsensitized pediatric recipients receiving a first kidney transplant
AU - Tagliamacco, Augusto
AU - Cioni, Michela
AU - Comoli, Patrizia
AU - Ramondetta, Miriam
AU - Brambilla, Caterina
AU - Trivelli, Antonella
AU - Magnasco, Alberto
AU - Biticchi, Roberta
AU - Fontana, Iris
AU - Dulbecco, Pietro
AU - Palombo, Domenico
AU - Klersy, Catherine
AU - Ghiggeri, Gian Marco
AU - Ginevri, Fabrizio
AU - Cardillo, Massimo
AU - Nocera, Arcangelo
PY - 2014
Y1 - 2014
N2 - Data on the different HLA-antibody (Ab) categories in pediatric kidney recipients developing de novo donor-specific Abs (DSA) after transplantation are scarce. We retrospectively evaluated 82 consecutive nonsensitized pediatric recipients of a first kidney graft for de novo HLA Ab occurrence and antigen specificity. At a median follow-up of 6 years, 29% of patients developed de novo DSA, while 45% had de novo non-DSA. DSA appeared at 25-month median time post-transplant and were mostly directed toward HLA-DQ antigens. Considering each HLA antigen, the estimated rate of DQ DSA (7.55 per 100 person-years) was much higher than the rates observed for non-DQ DSA. The HLA-DQ Ab recognized determinants of the DQβ chain in 70% of cases, α chain in 25% of cases, and both chains in one patient. Non-DSA peaked earlier than DSA, and were largely directed against HLA class I specificities that belonged to HLA-A- and HLA-B-related cross-reacting epitope groups (CREG) in 56% of cases. Our results indicate a need for evaluating HLA-DQ compatibilities in kidney allocation, in order to minimize post-transplant development of de novo DSA, known to be responsible for antibody-mediated rejection and graft loss.
AB - Data on the different HLA-antibody (Ab) categories in pediatric kidney recipients developing de novo donor-specific Abs (DSA) after transplantation are scarce. We retrospectively evaluated 82 consecutive nonsensitized pediatric recipients of a first kidney graft for de novo HLA Ab occurrence and antigen specificity. At a median follow-up of 6 years, 29% of patients developed de novo DSA, while 45% had de novo non-DSA. DSA appeared at 25-month median time post-transplant and were mostly directed toward HLA-DQ antigens. Considering each HLA antigen, the estimated rate of DQ DSA (7.55 per 100 person-years) was much higher than the rates observed for non-DQ DSA. The HLA-DQ Ab recognized determinants of the DQβ chain in 70% of cases, α chain in 25% of cases, and both chains in one patient. Non-DSA peaked earlier than DSA, and were largely directed against HLA class I specificities that belonged to HLA-A- and HLA-B-related cross-reacting epitope groups (CREG) in 56% of cases. Our results indicate a need for evaluating HLA-DQ compatibilities in kidney allocation, in order to minimize post-transplant development of de novo DSA, known to be responsible for antibody-mediated rejection and graft loss.
KW - Antibody-mediated rejection
KW - de novo HLA antibodies
KW - HLA donor-specific antibodies
KW - HLA matching
KW - pediatric kidney transplantation
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U2 - 10.1111/tri.12316
DO - 10.1111/tri.12316
M3 - Article
C2 - 24629017
AN - SCOPUS:84902544885
VL - 27
SP - 667
EP - 673
JO - Transplant International
JF - Transplant International
SN - 0934-0874
IS - 7
ER -