HLA‐DR and ‐DQ Eplet Mismatches and Transplant Glomerulopathy: A Nested Case–Control Study. Issue 1 (17th December 2014)

• Record Type: Journal Article
• Authors: Sapir‐Pichhadze, R.; Tinckam, K.; Quach, K.; Logan, A.G.; Laupacis, A.; John, R.; Beyene, J.; Kim, S.J.
• Is Part Of: American journal of transplantation. Volume 15:Issue 1(2015:Jan.)
• Page Start: 137
• Page End: 148
• Publication Date: 2014-12-17
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.12968
• Languages: English
• ISSNs: 1600-6135

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ajt12968-sec-0001" sec-type="section"> <p>We conducted a nested case–control study from a cohort of adult kidney transplant recipients to assess the risk of transplant glomerulopathy (TG) as a function of donor and recipient HLA‐DR and ‐DQ incompatibility at the eplet level. Cases (n = 52) were defined as patients diagnosed with transplant glomerulopathy based on biopsies showing glomerular basement membrane duplication without immune complex deposition. Controls (n = 104) with a similar follow‐up from transplantation were randomly selected from the remaining cohort. HLAMatchmaker was used to ascertain the number of DRB1/3/4/5, DQA1 and DQB1 related eplet mismatches (eplet load). Multivariable conditional logistic regression models demonstrated an increase in the odds of TG (odds ratios [OR] of 2.84 [95% confidence interval (CI): 1.03, 7.84] and 4.62 [95% CI: 1.51, 14.14]) in the presence of 27–43 and >43 HLA‐DR + DQ related eplet mismatches versus <27 eplet mismatches, respectively. When the eplet load was modeled as a continuous variable, the OR for TG was 1.25 (95% CI: 1.04, 1.50) for every 10 additional HLA‐DR + DQ eplet mismatches. Our study suggests that minimization of HLA‐DR + DQ eplet mismatches may decrease the incidence of transplant glomerulopathy diagnosed by indication biopsies. The role of eplet immunogenicity/antigenicity as determinants of allograft outcomes requires further study.</p> </sec> </abstract>