Renal allograft function impairment by posttransplant anti-HLA antibodies

Abstract

Objective To explore the impact of posttransplant anti-HLA antibodies on renal allograft function. Methods Fifty-seven patients with renal allografts for at least 6 months were detected for the levels and specialties of anti HLA antibodies by Flow PRA beads. The patients were divided into positive and negative groups according to different levels of anti-HLA antibodies. The positive group could be divided into three groups: anti-HLA class Ⅰ+ and class Ⅱ- ; anti-HLA class Ⅰ+ and class Ⅱ+; anti-HLA class Ⅰ-and class Ⅱ+. Simultaneously, their serum creatinine levels and clinical data were analyzed statistically. Results HLA antibodies were found in 28.1% (16/57) of the total patients. Three cases were positive for anti-HLA class I, 3 for both anti-HLA class Ⅰ and class Ⅱ antibodies, and 10 for anti-HLA class Ⅱ. The survival time of renal transplant patients was (4.55±3.16)and (6.64±3.66) years in anti-HLA antibodies negative and positive groups, respectively (P＜0.05). With the prolongation of time posttransplant, the positive rate of anti-HLA antibodies was increased. The levels of serum creatinine in 13 patients without anti-HLA antibodies were (92.12±27.52)μmol/L, and those in 13 patients with anti-HLA antibodies were (191.81±119.95)μmol/L.In anti-HLA antibodies positive group, the levels of serum creatinine in Ⅰ+ Ⅱ+ group were highest (213.00±165.38 μmol/L), and there was significant difference in comparison to anti-HLA antibodies group (P＜0.05). Conclusions The increases in anti-HLA antibodies could be one of the important prognostic markers in renal transplant. The renal allograft function could be impaired by the increased anti-HLA class Ⅱ. Key words: Kidney transplantation; HLA antigens; Transplantation immunology