Tuesday, March 18, 2014

DQ molecules are the principal stimulators of de novo donor specific antibodies in non sensitized pediatric recipients receiving a first kidney transplant

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 non-sensitized 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 towards 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 appeared earlier than DSA, were largely directed against HLA-class I specificities that belonged to HLA -A and -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 novoDSA, known to be responsible for antibody mediated rejection and graft loss (read more) Print this post

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