Donor-specific HLA-DQ antibodies may contribute to poor graft outcome after renal transplantation

Jennifer M. Devos, A. Osama Gaber, Richard J. Knight, Geoffrey A. Land, Wadi N. Suki, Lillian W. Gaber, Samir J. Patel

Research output: Contribution to journalArticlepeer-review

124 Scopus citations

Abstract

Increasing evidence suggests a detrimental effect of donor-specific antibodies directed against the human leukocyte antigen (HLA)-A, -B, and -DR loci on renal allograft outcomes. Limited data exist on the impact of de novo HLA-DQ antibodies. Over a 3-year period, we prospectively monitored 347 renal transplant recipients without pre-transplant donor-specific antibodies for their development de novo. After 26 months of follow-up, 62 patients developed donor-specific antibodies, of which 48 had a HLA-DQ antibody either alone (33 patients) or in combination with an HLA-A, -B, or -DR antibody (15 patients). Only 14 patients developed a donor-specific HLA-A, -B, or -DR antibody without a HLA-DQ antibody present. Acute rejection occurred in 21% of the HLA-DQ-only patients, insignificant when compared with 11% of patients without donor-specific antibodies. At the last follow-up, the mean serum creatinine and the fraction of patients with proteinuria were significantly higher in those that developed only HLA-DQ than those without antibodies. The 3-year graft survival was significantly worse when HLA-DQ antibodies were combined with non-DQ antibodies (52%) compared with HLA-DQ alone, non-DQ antibodies alone, or no antibodies (92-94%). Thus, our prospective monitoring study found that donor-specific HLA-DQ antibodies were the most common type detected and these antibodies may contribute to inferior graft outcomes. Ongoing surveillance is necessary to determine the long-term outcome of patients developing HLA-DQ donor-specific antibodies.

Original languageEnglish (US)
Pages (from-to)598-604
Number of pages7
JournalKidney international
Volume82
Issue number5
DOIs
StatePublished - Sep 1 2012

Keywords

  • antibody-mediated rejection
  • immunology
  • transplantation

ASJC Scopus subject areas

  • Nephrology

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