Donor-specific HLA antibodies and graft function in children after renal transplantation

Pediatr Nephrol. 2012 Jun;27(6):1011-9. doi: 10.1007/s00467-012-2101-4. Epub 2011 Oct 13.

Abstract

Background: The presence of circulating donor-specific human leukocyte antigen antibodies (HLA-DSA) has been associated with chronic antibody-mediated rejection, leading to progressive graft dysfunction and poor graft survival.The aim of this study was to investigate the incidence and significance of HLA-DSA in paediatric renal transplantation(RTx) patients.

Methods: A total of 294 post-transplant serum samples from 123 RTx patients were retrospectively analysed for HLA antibodies. Positive samples were further tested for HLADSA by a Luminex Single Antigen bead assay. The antibody findings were correlated to measured glomerular filtration rate(GFR) and clinical outcome.

Results: HLA antibodies were detected in half of the routine samples (140/294) taken 1 month to 10 years after RTx, and 40% (62/140) of these were HLA-DSA. Overall, one-third(42/123) of the patients had HLA-DSA, which mostly(65%) reacted against class II antigens. Detection of HLADSA was not associated with poor GFR at the time of sampling, and no exceptional deterioration of GFR after the HLA-DSA detection was noted in individual patients regardless of the antibody level. The presence of HLA-DSA in the first 2 years posttransplantation was not associated with poorer graft function later on.

Conclusion: Detection of HLA antibodies is common in children after RTx, and this finding, as such, does not predict any deterioration of graft function.

MeSH terms

  • Adolescent
  • Adult
  • Analysis of Variance
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Female
  • Finland
  • Glomerular Filtration Rate*
  • Graft Rejection / immunology
  • Graft Rejection / physiopathology
  • Graft Survival
  • HLA Antigens / immunology*
  • Histocompatibility*
  • Humans
  • Infant
  • Isoantibodies / blood*
  • Kidney / immunology
  • Kidney / physiopathology
  • Kidney / surgery*
  • Kidney Transplantation / immunology*
  • Male
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • HLA Antigens
  • Isoantibodies