Clinical Impact of Preformed Donor Specific Denatured Class I HLA Antibodies after Kidney Transplantation

Class I single antigen flow beads (SAFB) carry native and denatured HLA molecules. Using a cohort of 179 class I HLA sensitised kidney recipients, we described incidence and clinical relevance of preformed denatured HLA Donor Specific Antibodies (DSA) using two different assays: an acid-treated SAFB assay (anti-dHLA DSA) and the iBeads assays (SAFB+/iBeads- DSA). Eighty-five class I DSA were found in 67 patients [median mean fluorescence intensity (MFI) of 1729 (range 520-13882)]. Anti-dHLA and SAFB+/iBeads- DSA represented 11% and 18% of class I DSA and were mainly low MFI DSA (500-1000 MFI). Concordance between these two assays was good (90%). None of the patients with only class I anti-dHLA DSA or only SAFB+/iBeads- DSA developed acute clinical AMR in the first year post-transplantation, and their 5-year DCGS was similar to that of patients without DSA. Moreover, all these patients displayed a negative current T-cell flow cytometry crossmatch. Therefore, both anti-dHLA DSA and SAFB+/iBeads- DSA appear irrelevant, which could explain the good outcome observed in some patients with preformed class I DSA (read more) Print this post