Association Between HLA Antibodies and Different Sensitization Events in Renal Transplant Candidates.
Date
2017Author
Caliskan, Y.
Canitez, I. O.
Demir, E.
Yazici, Halil
Bakkaloglu, H.
Aydin, A. E.
Turkmen, A.
Nane, I.
Aydin, F.
Oguz, F. S.
Akgul, Sebahat
Ciftci, H. S.
Temurhan, Sonay
Bayraktar, Adem
Tefık, Tzevat
Kaya, İsmail
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Background. Human leukocyte antigen (HLA) allo-immunization is caused by variousevents such as blood transfusions, pregnancies, or organ transplantations, which can leadto sensitization. In this retrospective study, we evaluated different sensitization models andtheir effects on panel-reactive antibody (PRA) profiles of renal transplantation candidates.Methods. Anti-HLA class I/II antibody screening tests were performed in 906 renaltransplantation candidates with the use of a microbead-based assay (Luminex).Results. Two hundred ninety-seven (32.8%) of the patients were determined as positivein terms of PRA, and 609 (67.2%) were negative. Sensitized and non-sensitized patientswere compared separately in terms of each sensitization type. The anti-HLA class I, II,and IþII positivity rates in patients sensitized only by blood transfusion were 13.1%,6.3%, and 14.1%, the rates with pregnancy sensitization were 35.5%, 29%, and 45.2%,and rates with previous transplantation sensitization were 15.6%, 34.4%, and 38.9%,respectively. Prevalence of PRA positivity was significantly higher in patients withprevious pregnancy than with transplantation and transfusion (odds ratio, 1.003; 95%confidence interval, 0.441e2.281; P ¼ .031). The risk of developing HLA class Iantibodies was higher in pregnancies (P < .001), and the risk of developing anti-HLAclass II antibodies was higher in patients who had undergone a previous transplantation(P < .001). The rate of developing HLA-B antibodies in patients sensitized bypregnancy were significantly higher compared with sensitization after transfusion(P ¼ .015), as was the rate of developing HLA-DQ antibodies in patients sensitized byprevious transplantation compared with sensitization through pregnancy (P ¼ .042).Conclusions. In patients who are waiting for kidney transplantation, sensitization bypregnancy and transplantation have a significant impact on development of HLA class Iand class II antibodies.
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