Impact of Anti-HLA-DR51/52/53 Antibody Positivity on Predicting Flow Cytometry Crossmatch Results in Kidney Transplant Candidates
ABSTRACT
Objectives:
Genetic differences between the patient and the donor and the immune system cells response to these differences are among the causes of allograft rejection. Human leukocyte antigen (HLA)-DR, DP, DQ antigens have been shown to be expressed in renal epithelial cells, and in addition, a marked increase in HLA class-II expression has been reported in rejected renal allografts. Human leukocyte antigen-DR contributes to the rejection process due to its role in the activation of CD4⁺ T cells. Polymorphism in the HLA-DRB3 (DR52), DRB4 (DR53), and DRB5 (DR51) loci is weak, and they are not encoded by the same loci as HLA-DRB1. In addition, these loci are inherited together with the alleles of the DRB1 locus encoding HLA antigens. In our study, we aimed to investigate the correlation between anti-HLA DR51/52/53 antibody positivity detected alone or in combination in the sera of patients on the kidney transplant waiting list and flow cytometry crossmatch (FCXM) positivity.
Materials and Methods:
In our study, the panel reactive antibody (PRA) identification and FCXM test results of 200 patients who tested positive for PRA screening between 2019 and 2023 at the Tissue Typing Laboratory of İstanbul Faculty of Medicine were retrospectively analysed.
Results:
Of the patients included in the study, PRA screening tests were positive (n=200), and antibodies against at least one antigen belonging to the anti-HLA-DR51/52/53 subgroups were detected in 55.5% (n=111) of these patients in the PRA identification test. All alleles in the DR51, DR52, DR53 subgroups were found to be associated with FCXM-B positivity. In addition, DR16 (p=0.017) correlated with FCXM-T positivity both alone and in combination with DR15 (p=0.019), while in the DR52 subgroup, the simultaneous positivity of DR13, DR14, DR17, and DR18 (p=0.027) was significantly correlated with FCXM-T positivity.
Conclusion:
The findings obtained in our study suggest that HLA-DR51/52/53 antibodies may be effective in predicting FCXM positivity.
Keywords:
Donor specific antibody,
flow cytometry crossmatch,
HLA-DRB3,
HLA-DRB4,
HLA-DRB5.
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