Serum analysis after transplant nephrectomy reveals restricted antibody specificity patterns against structurally defined HLA class I mismatches

Oyedele A. Adeyi, Alin L. Girnita, Judy Howe, Marilyn Marrari, Yehia Awadalla, Medhat Askar, Joan Martell, Adrian Zeevi, Ron Shapiro, Michael Nalesnik, Parmjeet Randhawa, Anthony J. Demetris, René J. Duquesnoy

Research output: Contribution to journalArticlepeer-review

78 Scopus citations

Abstract

This study deals with HLA-mismatched kidney transplants that have been removed following rejection. Sera from 27 patients were screened for HLA-specific antibodies by direct complement-dependent lymphocytotoxicity with HLA-typed cell panels. Circulating donor-specific antibodies were detected in 3 cases (11%) before and in 26 cases (97%) after allograft nephrectomy. These findings demonstrate the production of donor-specific antibodies in patients with rejected transplants, but in most cases, they were undetectable before nephrectomy, because the graft had adsorbed them. With an HLAMatchmaker-based serum analysis program, we observed restricted antibody specificity patterns against amino acid triplet-defined epitopes on donor HLA-A,B antigens. Many donor triplets were non-reactive while others were apparently recognized by antibodies. In some patients, the donor triplet specific antibodies persisted for a long time whereas in many other patients, they became undetectable after a few months. The characterization of the antibody specificity profiles of post-allograft nephrectomy sera is clinically useful in defining criteria of HLA mismatch acceptability for sensitized patients awaiting another transplant. It provides also opportunities for determining the relative immunogenicity of mismatched triplets.

Original languageEnglish (US)
Pages (from-to)53-62
Number of pages10
JournalTransplant Immunology
Volume14
Issue number1
DOIs
StatePublished - Mar 2005

Keywords

  • Alloantibodies
  • Allograft nephrectomy
  • HLAMatchmaker
  • Kidney transplant
  • Serum analysis
  • Triplet

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