Clinical risk stratification ofde novo DSA after kidney transplantation based upon eplet mismatch / 中华器官移植杂志

ABSTRACT

Objective To compare HLA loci versus eplet match in predicting de novo DSA after renal transplantation and establish a risk stratification scheme based upon eplet mismatch for predicting the risk of de novo DSA .Methods A retrospective analysis of HLA serological versus and eplet mismatch was performed for 141 pairs of donors and recipients .And the predictive power of de novo DSA was evaluated by the follow-up results .Based upon eplet mismatch ,a preliminary scheme of risk stratification was established and experimentally verified .Results No significant difference existed in HLA serological mismatch between de novo DSA and DSA negative groups (10 .40 vs 8 .94 ,P=0 .1224) while there was a significant difference in eplet mismatch (100 .60 vs 70 .37 , P< 0 .0001 ) . The risk stratification scheme based upon HLA serological mismatch could not differentiate de novo DSA-free rates between low/medium/high-risk groups (100％ vs 94 .74％ vs 90 .41％ , P=0 .4485 , P=0 .4506 , P=0 .2060 ) .Instead the novel scheme based upon eplet mismatch revealed significant difference in the prevalence of de novo DSA between low /medium/high-risk groups (100％ vs 91 .04％ vs 66 .67％ ,P=0 .0001 ,P=0 .0001 ,P<0 .0001) .Conclusions As a better tool of predicting de novo DSA ,Eplet match is vital for the risk stratification scheme of de novo DSA .