Turkish Journal of Nephrology
Original Article

Do Xenogeneic Anti-HLA-A3 Antibody Cause AntibodyMediated Rejection in Kidney Transplant?

1.

Department of Medical Biology, İstanbul University Istanbul Faculty of Medicine, İstanbul, Türkiye

2.

Department of General Surgery, İstanbul University Istanbul Faculty of Medicine, İstanbul, Türkiye

3.

Transplant Immunology Research Center of Excellence, Koç University Hospital, Koç University, İstanbul, Türkiye

4.

Division of Nephrology, Department of Internal Medicine, İstanbul University Istanbul Faculty of Medicine, İstanbul, Türkiye

Turkish J Nephrol 2024; 33: 102-109
DOI: 10.5152/turkjnephrol.2023.22486
Read: 142 Downloads: 77 Published: 05 January 2024

Objective: Anti-thymocyte globulin-Fresenius is used for induction treatment in kidney transplantation. The antibody of rabbit originated against human leukocyte antigen A3 were demonstrated in the serum of patients who used antithymocyte globulin-Fresenius. We investigated whether anti-human leukocyte antigen A3 antibodies detected due to anti-thymocyte globulin administration had any efect on patient and allograf survival in short- and long-term follow-up.

Methods: Fify-one patients who underwent kidney transplantation between 2004 and 2014 were included in the study. Twenty-nine patients who underwent transplantation from deceased donors received an induction therapy consisting of anti-thymocyte globulin-Fresenius. Antibodies against the human leukocyte antigen were identified using the LABScreen panel reactive antibody class I/II kits with the Luminex method. The graf function and loss, patient survival, and the presence of acute/chronic rejection were investigated.

Results: Anti-human leukocyte antigen A3 antibody was detected in 41.3% of the patients receiving anti-thymocyte globulin induction (P = .001). This antibody disappeared at 234.4 days posttransplant. No diference was found regarding pretransplant and posttransplant sensitization of the patients who had posttransplant anti-human leukocyte antigen A3 positivity. The anti-thymocyte globulin dose and administration period were similar for anti-human leukocyte antigen A3 antibodypositive and -negative patients (P >.05). There was no significant diference between groups in short-term, first year, and long-term results of serum creatinine, estimated glomerular filtration rate, and proteinuria values (P >.05).

Conclusion: We demonstrated that xenogeneic anti-human leukocyte antigen A3 antibody could be detected in posttransplant serum of patients receiving anti-thymocyte globulin induction independent of the dose and duration. The development of this antibody was independent of the exposure of the patient to pre- and posttransplant sensitizing event or the presence of human leukocyte antigen A3 in the allograf. While this study did not demonstrate the efect of xenogeneic anti-human leukocyte antigen A3 antibody on graf and patient survival, retrospective multicenter cohort studies are needed on this issue.

Cite this article as: Usta Akgul S, Temurhan S, Kekik Cınar C, et al. Do xenogeneic anti-HLA-A3 antibody cause antibody-mediated rejection in kidney transplant? Turk J Nephrol. 2024;33(1):102-109.

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