HLA class I residue mismatch and renal graft outcome

Transpl Int. 2000;13 Suppl 1:S444-8 doi: 10.1007/s001470050379.

Donor-recipient HLA matching was retrospectively evaluated in 111 cadaveric renal transplants using Takemoto's ten-residue model in which HLA class I antigens are clustered by crossreactive group (CREGs) on the basis of amino acid sequence homology and the sharing of a particular public epitope. The grade and type of HLA residue mismatching were correlated to posttransplant, class I donor-specific antibody production (monitored by flow cytometry crossmatch), rejection occurrence and clinical outcome during the 1st year posttransplant. In 52 patients with 0 mismatchings (MMs) we observed a low incidence of rejection (11.1%) and antibody production (11.1%) for 0 CREG MM grade, while 1 MM was enough to increase immune response against graft (rejection 35%; antibodies 30%). Moreover, a significant correlation was observed between Q144, E163, Q62 and L82/R82 epitopes and the incidence of acute rejection and antibody production ("immunogenic" residues) in patients grouped for a single residue mismatch.

LEVEL OF EVIDENCE: Case Series / Case Control / Cohort
MESH HEADINGS: Antibody Formation; Cadaver; Epitopes; Graft Rejection; Graft Survival; Histocompatibility Antigens Class I; Histocompatibility Testing; Humans; Immunoglobulin G; Immunoglobulin M; Kidney Transplantation; Retrospective Studies; Tissue Donors; Treatment Outcome