期刊
EXPERIMENTAL AND CLINICAL TRANSPLANTATION
卷 17, 期 -, 页码 6-17出版社
BASKENT UNIV
DOI: 10.6002/ect.MESOT2018.L30
关键词
Acute rejection; Allograft dysfunction; Allograft fibrosis; Donor-specific antibodies; Epitope
资金
- National Center for Advancing Translational Science (NCATS), a component of the National Institutes of Health [UL1 TR000142]
- National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health [P30KD034989]
Objectives: To identify the risk of developing acute rejection, allograft fibrosis, and antibody-mediated rejection, a retrospective review of pediatric patients who underwent liver transplant between July 31, 1998 and February 29, 2016 and had donor-specific antibodies measured at time of liver biopsy was undertaken. Materials and Methods: HLAMatchmaker Software (http://www.hlamatchmaker.net) was used to define epitope mismatches between donors and recipients and to predict de novo donor-specific antibody risk. Epitope mismatches were evaluated for their immunogenicity. Results: In our group of 42 recipients, 20 (48%) had donor-specific antibodies. Having an antibody against HLA-DQB1*02 was associated with acute rejection (66.6% vs 36%; P = .024). We found that DQ epitope mismatch load was greater in recipients with class II donor-specific antibodies (9.7 vs 3.6; P=.001). HLA-DQ (7.4 vs 3.6; P = .04) and H LA-DR (8.8 vs 3.8; P = .04) epitope mismatch loads were higher in recipients with DQ + DR donor-specific antibodies. A high portal fibrosis score was associated with higher mismatch load at the DQ locus (P = .005) and DQ + DR loci (P = .03). Having > 5 or > 6 epitope mismatch loads at the DQ locus identified a threshold above which development of DQ donor-specific antibodies would occur (area under the curve = 0.878). Mismatches for eplet 4Q, 45GE, 52PQ, and 52PL, thought to be immunodominant epitopes, were observed for several recipients. Conclusions: Knowledge of epitope mismatches between recipients and donors may aid transplant physicians in devising immunosuppression strategies.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据