Comparison of HLA and Non-HLA Antibodies Regarding to Rejection Pattern of the Kidney Transplantation

Abstract

Objective: Antibodies against HLA class I and II antigens are important in kidney transplantations because they cause rejections. Not only antibodies against HLA antigens but also those against non-HLA antigenic system play a role in antibody mediated rejections. In this study it was aimed to detect HLA-and non-HLA antibodies in individuals that experienced rejection attack. Method: Thirteen patients, who clinically experienced rejection episodes according to the biochemical test results after transplantation, were tested by lymphocyte crossmatch (by using the lymphocytes of their living related donors) and non-HLA specific anti-endothelial crossmatch methods. Results: Antibodies specific for Tie-2 receptor positive cells were not detected. The results of XM-ONE cross-match and flow crossmatch tests were found to be compatible with each other. Conclusion: In conclusion, it was considered that immunosuppressive treatment protocols and surgical complications play important role in rejection attacks. Further studies can contributed to determination of graft survival.

Antigen and Cell-Based Assays for the Detection of Non-HLA Antibodies

“…Additionally, this non-HLA antibody seemed to be associated with negative clinical outcome on the graft that was independent of the HLA-DSA status. These results were confirmed in a smaller cohort by Senev et al (22) Interestingly, these results of a negative clinical outcome when non-HLA antibodies are present in the pretransplant sera were similar to what has been published by other groups for other types of non-HLA antibodies [namely, the studies by Soyöz et al and Zitzner et al (26,27)]. This especially holds true with regard to the presence and clinical relevance of non-HLA antibodies in living donor compared with deceased donor transplantation.…”

“…post-transplant serum from 13 living donor transplant recipients using the XM-ONE kit. In this population, AECAs were not detectable in the serum samples of all patients including the three patients who experienced ABMR (26). In addition, Zitzner et al also investigated the presence of AECAs in the pre-transplant serum samples of 150 living donor kidney transplant recipients and reported a lack of association between the XM-ONE result and biopsy-proven rejection or vasculopathy at 1-year posttransplant (27).…”

“…Several other studies utilized the XM-ONE setup to screen for the presence of non-HLA antibodies in living donor kidney transplant recipients. These studies describe contrasting results (26,27) a Sample details as well as the type of assay pertain only to the non-HLA detection method described in the article and not the entire methodology section.…”

“…However, despite a large number of published assays, screening for the presence of non-HLA antibodies has still not entered routine clinical practice in transplant medicine. Endothelial crossmatching assays have been used to detect non-HLA antibodies with flow cytometry (e.g., XM-ONE) (21,(24)(25)(26)(27). In addition, enzyme-linked immunosorbent assay (ELISA), high-density protein arrays, indirect immunofluorescence, and serological analysis of recombinant cDNA expression libraries (SEREX) have also been described (28)(29)(30).…”