Anti‐HLA antibody status in kidney transplant candidate

Abstract

We aimed to demonstrate the anti‐HLA antibody status of the end‐stage renal disease patients whose antibody screening and identification tests were performed. Two hundred fifty‐six patients (female/male,152/104) who were tested for anti‐HLA antibodies between 2017‐2020 were included in the study. Anti‐HLA antibody screening and identification tests were performed using an Luminex method. FCXM and CDCXM tests were performed with the donor derived fresh cells. PRA(+) group (MFI≥1000) consisted of 202 (78.9%) patients. Of the PRA(+) patients, 20.0% were only class I (+); 40.0% were only class II (+); 40.0% were both class I‐II (+). The single antigen bead (SAB)(+) group consisted of 172 (67.2%) patients. Of the SAB(+) patients, 25.0% were only class I (+); 37.2% were only class II (+); 37.8% were both class I‐II (+). FCXM(+) group consisted of 133 (52%) patients. Of the FCXM(+) patients, 63,2% were only FCXM‐B(+), 36.8% were both FCXM‐T‐B(+). CDC positivity was found as 10.5% in 256 patients. PRA and SAB positivity was significantly associated with female gender (p=0.028) [MFI(median) Class I: 5500/Class II: 5604],pregnancy (p=0.012) [MFI(median) Class I: 8191 Class II: 7720], blood transfusions (p=0.06) [MFI(median) Class I: 4891 Class II: 8562], previous transplantation history (P<0.0001) [MFI(median) Class I: 4950/Class II:14198]. Anti‐A24, anti‐B51, anti DR15, anti‐DQ7 were the most frequent antibodies in this group. Our results showed that previous transplantation affect the antibody production of MFI levels of class II in sensitized patients and confirmed the significant correlation between female gender, pregnancy, blood transfusions and previous transplantation history with PRA and SAB positivity.