Is the level of HLA eplet mismatch a risk factor for graft loss among kidney transplant recipients who have already formed de novo donor specific antibody?

Is the level of HLA eplet mismatch a risk factor for graft loss among kidney transplant recipients who have already formed de novo donor specific antibody?

Is the level of HLA eplet mismatch a risk factor for graft loss among kidney transplant recipients who have already formed de novo donor specific antibody?

Eplet mismatches are related to de novo DSA (dnDSA) and antibody mediated rejection (ABMR) among the many common kidney transplant inhabitants. Nevertheless, it’s unclear whether or not the extent of eplet mismatch can be utilized for threat stratification amongst sufferers with dnDSA. We carried out a retrospective observational research of kidney transplant recipients with dnDSA (n = 44) transplanted between 10/2007 and 5/2014 to guage eplet mismatch as a threat issue for ABMR and allograft loss amongst dnDSA sufferers.

Excessive decision typing was inferred from by imputation primarily based on ethnicity and NMDP haplotypes, and the eplet mismatch was calculated utilizing the Epvix algorithm. Biopsies (N = 151) from 95.3%(42/44) of sufferers had been reviewed. The imply (SD) eplet mismatch was 69.8(22.8). The ABMR incidence was 71.4% (30/42) and 5 yr loss of life censored allograft survival was 67.4% throughout the imply (SD) follow-up of 5.3 (3.1) years. ABMR and death-censored allograft survival weren’t correlated with eplet mismatch amongst dnDSA sufferers.

Nevertheless, treatment adherence and dnDSA MFI < 3000 had been related to decreased ABMR incidence. Amongst sufferers with each of those favorable traits, solely 35.7% (15/42) developed ABMR. In conclusion, the extent of eplet mismatch doesn’t correlate with ABMR or allograft loss amongst excessive threat kidney transplant sufferers with dnDSA.