Human leukocyte antigen immunization in transfusion-dependent Moroccan patients with beta-thalassemia major: prevalence and risk factors.

INTRODUCTION: Beta-thalassemia major patients need a regular blood transfusion to have an initial normal growth. However, these patients have an increased risk of developing alloantibodies. Our main goal was to study HLA alloimmunization in Moroccan Beta-thalassemia patients by confronting it with transfusion and demographic criteria, exploring the involvement of HLA typing profile in the development of HLA antibodies and in turn determining risk factors for their development. METHODS: The study consisted of 53 Moroccan pediatric patients with Beta-thalassemia major. Screening for HLA alloantibodies was performed using Luminex technology Whereas HLA genotyping was done with sequence-specific primers (PCR-SSP). RESULTS: In this study, 50.9% of patients have been identified as positive for HLA antibodies, with 59.3% having both HLA Class I and Class II antibodies. A significant increase frequency of DRB1*11 allele was revealed in non-immunized patients (34.6% vs. 0%, p = 0.001). Our results also revealed that the majority of our HLA immunized patients were women (72.4% vs. 27.6%, p = 0.001), and transfused with more than 300 units of RBC units (66.7% vs. 33.3%, p = 0.02). There were statistically significant differences when comparing these frequencies. CONCLUSIONS: This paper revealed that the transfusion dependent Beta-thalassemia major patients are exposed to risk of developing HLA antibodies following transfusions with leukoreduced RBC units. The HLA DRB1*11 was a protective factor against HLA alloimmunization in our beta-thalassemia major patients.

[Husband to wife renal transplantatation and pretransplant HLA immunization: about two cases]. / Transplantation rénale entre époux et immunisation anti-HLA en prégreffe: à propos de deux observations.

Renal transplantation is the best therapeutic approach for end-stage kidney disease. Renal transplantation can be performed using living donors or brain-dead donors. Vaccination in recipients poses a real problem with the transplantation process because it is responsible for particular difficulties in choosing a donor and above all exposes to the risk of transplant rejection. We here report two cases of husband to wife renal transplantation. The recipients had low levels of antibodies against HLA antigens of donors but sex-associated differences in post-transplant results were found. Indeed, HLA immunization after pregnancy is a real obstacle to husband to wife renal transplantation. Despite the low husband-wife HLA matching (unrelated donor), renal transplantation is a good alternative for renal transplantation from brain-dead donors, who are lacking in Morocco.