PMID- 22735711
OWN - NLM
STAT- MEDLINE
DCOM- 20120927
LR  - 20220409
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 94
IP  - 2
DP  - 2012 Jul 27
TI  - De novo DQ donor-specific antibodies are associated with a significant risk of 
      antibody-mediated rejection and transplant glomerulopathy.
PG  - 172-7
LID - 10.1097/TP.0b013e3182543950 [doi]
AB  - BACKGROUND: The importance of human leukocyte antigen (HLA) matching in renal 
      transplantation is well recognized, with HLA-DR compatibility having the greatest 
      influence. De novo DQ donor-specific antibodies (DSAbs) are the predominant HLA 
      class II DSAb after transplantation. The aim of this study was to establish the 
      incidence and outcomes after the development of DQ DSAbs along with the impact of 
      class II HLA mismatch on their development. METHODS: We retrospectively analyzed 
      505 patients who received a renal-alone transplant between 2005 and 2010. We 
      excluded patients who received an ABO- and HLA-incompatible allograft, which we 
      defined as those with a positive crossmatch or preformed DSAbs detected by 
      single-antigen beads only. RESULTS: Of 505 patients, 92 (18.2%) developed DSAbs, 
      with 50 (54.3%) of these 92 patients having DQ DSAbs. Patients who developed DQ 
      DSAbs were at significant risk for antibody-mediated rejection, transplant 
      glomerulopathy, and allograft loss (P<0.0001). Of 505 patients, 108 (21.4%) were 
      matched at both the DR and DQ loci, 284 (56.2%) were mismatched at both loci, 38 
      (7.5%) were matched at DR alone, and 75 (14.9%) were matched at DQ alone. 
      Patients mismatched at both DR and DQ were at risk for developing class II DSAbs 
      when compared with those mismatched at either DR or DQ alone, P=0.001, and were 
      at risk for antibody-mediated rejection, P=0.001. CONCLUSIONS: DQ DSAbs are 
      associated with inferior allograft outcomes. This study shows the importance of 
      establishing the DQ match before transplantation to define immunologic risk.
FAU - Willicombe, Michelle
AU  - Willicombe M
AD  - Imperial College Kidney and Transplant Centre, Hammersmith Hospital, London, UK. 
      Michelle.Willicombe@imperial.nhs.uk
FAU - Brookes, Paul
AU  - Brookes P
FAU - Sergeant, Ruhena
AU  - Sergeant R
FAU - Santos-Nunez, Eva
AU  - Santos-Nunez E
FAU - Steggar, Corinna
AU  - Steggar C
FAU - Galliford, Jack
AU  - Galliford J
FAU - McLean, Adam
AU  - McLean A
FAU - Cook, Terence H
AU  - Cook TH
FAU - Cairns, Tom
AU  - Cairns T
FAU - Roufosse, Candice
AU  - Roufosse C
FAU - Taube, David
AU  - Taube D
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (HLA-DQ Antigens)
RN  - 0 (HLA-DR Antigens)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Graft Rejection/*etiology
MH  - Graft Survival
MH  - HLA-DQ Antigens/genetics/*immunology
MH  - HLA-DR Antigens/genetics
MH  - Histocompatibility Testing
MH  - Humans
MH  - Isoantibodies/*immunology
MH  - Kidney Diseases/*etiology
MH  - Kidney Glomerulus/*pathology
MH  - Kidney Transplantation/*adverse effects
MH  - Linkage Disequilibrium
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *Tissue Donors
MH  - Transplantation, Homologous
EDAT- 2012/06/28 06:00
MHDA- 2012/09/28 06:00
CRDT- 2012/06/28 06:00
PHST- 2012/06/28 06:00 [entrez]
PHST- 2012/06/28 06:00 [pubmed]
PHST- 2012/09/28 06:00 [medline]
AID - 10.1097/TP.0b013e3182543950 [doi]
PST - ppublish
SO  - Transplantation. 2012 Jul 27;94(2):172-7. doi: 10.1097/TP.0b013e3182543950.