DQ molecules are the principal stimulators of de novo donor‐specific antibodies in nonsensitized pediatric recipients receiving a first kidney transplant. (25th April 2014)

• Record Type: Journal Article
• Authors: Tagliamacco, Augusto; Cioni, Michela; Comoli, Patrizia; Ramondetta, Miriam; Brambilla, Caterina; Trivelli, Antonella; Magnasco, Alberto; Biticchi, Roberta; Fontana, Iris; Dulbecco, Pietro; Palombo, Domenico; Klersy, Catherine; Ghiggeri, Gian Marco; Ginevri, Fabrizio; Cardillo, Massimo; Nocera, Arcangelo
• Is Part Of: Transplant international. Volume 27:Number 7(2014:Jul.)
• Page Start: 667
• Page End: 673
• Publication Date: 2014-04-25
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95405
• DOI: 10.1111/tri.12316
• Languages: English
• ISSNs: 0934-0874

Abstract

<abstract abstract-type="main" id="tri12316-abs-0001"> <title>Summary</title> <p>Data on the different HLA‐antibody (Ab) categories in pediatric kidney recipients developing <italic>de novo</italic> donor‐specific Abs (DSA) after transplantation are scarce. We retrospectively evaluated 82 consecutive nonsensitized pediatric recipients of a first kidney graft for <italic>de novo</italic> HLA Ab occurrence and antigen specificity. At a median follow‐up of 6 years, 29% of patients developed <italic>de novo</italic> DSA, while 45% had <italic>de novo</italic> 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 <italic>de novo</italic> DSA, known to be responsible for antibody‐mediated rejection and graft loss.</p> </abstract>