ABSTRACT
HLA-DQB1*02:01:01:21Q differs from HLA-DQB1*02:01:01:01 by one nucleotide substitution in the splice site in the beginning of intron 3.
Subject(s)
Base Sequence , Humans , Alleles , HLA-DQ beta-Chains/genetics , IntronsABSTRACT
HLA-DQA1*01:03:11 differs from HLA-DQA1*01:03:01:02 by one nucleotide substitution in codon 59 in exon 2.
Subject(s)
Nucleotides , Humans , Alleles , HLA-DQ alpha-Chains/genetics , Exons/geneticsABSTRACT
HLA-DPB1*1516:01 differs from HLA-DPB1*1229:01 by seven nucleotide substitutions in exon 3.
Subject(s)
Base Sequence , Humans , Alleles , HLA-DP beta-Chains/genetics , Exons/geneticsABSTRACT
HLA-DRB3*02:194 differs from HLA-DRB3*02:02:01:02 by one nucleotide substitution in codon 78 in exon 2.
Subject(s)
Base Sequence , Humans , HLA-DRB3 Chains/genetics , Alleles , Histocompatibility Testing , Codon , Sequence Analysis, DNA , HLA-DRB1 ChainsABSTRACT
T-cell mediated rejection (TCMR), de novo anti-HLA donor-specific antibodies (dnDSAs) and ensuing antibody-mediated rejection (ABMR) reduce kidney transplantation (KT) survival. The immunomodulatory effects of 25-hydroxyvitamin D [25(OH)D] could be beneficial for KT outcomes. We aimed to evaluating the association between 25(OH)D levels, the development of dnDSAs, clinical TCMR and ABMR, and graft survival. This single center retrospective study included 253 KT recipients (KTRs) transplanted without preformed DSA between 2010 and 2013. We measured 25(OH)D in successive serum samples: at KT (M0) and M12 for the entire cohort, and additionally at M24 and/or M36 when sera were available. We assessed graft outcomes up to 5 years post-KT. The proportion of KTRs having sufficient 25(OH)D at KT (M0) was high (81.4%) and then dropped at M12 (71.1%). KTRs with sufficient 25(OH)D at M0 experienced less clinical TCMR (HR, 0.41; 95% CI, 0.19-0.88 in multivariate analysis). A sufficient 25(OH)D at M12 was independently associated with a longer dnDSA-free survival (HR, 0.34; 95% CI, 0.17-0.69). There was no association between 25(OH)D and clinical AMBR. Studying the KTRs with 25(OH)D measurements at M12, M24 and M36 (n = 203), we showed that 25(OH)D sufficiency over the 3 first-years post-KT was associated with a longer graft survival in multivariate analyses (HR, 0.39; 95% CI, 0.22-0.70). To our knowledge, this study is the first showing an association between 25(OH)D sufficiency post-KT and dnDSA occurrence in KTRs. Moreover, we reinforce previously published data showing an association between 25(OH)D, TCMR and graft survival in KT.
Subject(s)
Kidney Transplantation , Vitamin D/analogs & derivatives , Humans , Retrospective Studies , Risk Factors , HLA Antigens , Alleles , Antibodies , Graft Rejection , IsoantibodiesABSTRACT
HLA-DRB1*13:03:13 differs from HLA-DRB1*13:03:01:01 by one nucleotide substitution in codon 180 in exon 3.
Subject(s)
HLA-DRB1 Chains , Humans , HLA-DRB1 Chains/genetics , Base Sequence , Alleles , Exons/genetics , CodonABSTRACT
HLA-DRB1*11:324 differs from HLA-DRB1*11:62:02 by one nucleotide substitution in codon 38 in exon 2.
Subject(s)
HLA-DRB1 Chains , Humans , HLA-DRB1 Chains/genetics , Base Sequence , Alleles , Exons/genetics , CodonABSTRACT
HLA-B*08:312 differs from HLA-B*08:01:01:01 by one nucleotide substitution in codon 324 in exon 6.
Subject(s)
HLA-B Antigens , Humans , Alleles , Histocompatibility Testing , Codon , Sequence Analysis, DNAABSTRACT
The selection of a donor is an essential element in allogeneic hematopoietic stem cell transplantation. In the absence of an HLA-matched related donor, the selection of an unrelated donor is considered, and is currently the most common type of allogenic donor used in practice. Many criteria are considered for the selection when multiple donors are available, particularly in case of partial match. The aim of this workshop is to assist in the selection of an unrelated donor, in keeping with recent data from the literature.
Subject(s)
Bone Marrow Transplantation , Hematopoietic Stem Cell Transplantation , Humans , Unrelated Donors , Donor Selection , Societies, MedicalABSTRACT
HLA-B*44:324:02 differs from HLA-B*44:324:01 by one nucleotide substitution in codon 99 in exon 3.
Subject(s)
HLA-B Antigens , Humans , Alleles , Histocompatibility Testing , Codon , Sequence Analysis, DNAABSTRACT
HLA-DRB1*01:140 differs from HLA-DRB1*01:02:01:01 by one nucleotide substitution in codon 147 in exon 3.
Subject(s)
HLA-DRB1 Chains , Humans , HLA-DRB1 Chains/genetics , Base Sequence , Alleles , Exons/genetics , CodonABSTRACT
HLA-DPA1*02:01:21 differs from HLA-DPA1*02:01:01:03 by one nucleotide substitution in codon 190 in exon 4.
Subject(s)
HLA-DP alpha-Chains , Humans , Alleles , Sequence Alignment , Histocompatibility Testing , HLA-DP alpha-Chains/genetics , Sequence Analysis, DNAABSTRACT
HLA-DQA1*02:01:14 differs from HLA-DQA1*02:01:01:02 by one nucleotide substitution in codon 105 in exon 3.
Subject(s)
Alleles , Humans , HLA-DQ alpha-Chains/genetics , Sequence Analysis, DNA , CodonABSTRACT
HLA-B*15:01:01:65Q differs from HLA-B*15:01:01:01 by one nucleotide substitution in the splice site in the beginning of intron 3.
Subject(s)
HLA-B Antigens , Humans , Base Sequence , Alleles , Histocompatibility Testing , Exons/genetics , Sequence Analysis, DNAABSTRACT
HLA-C*07:1023 differs from HLA-C*07:01:01:01 by one nucleotide substitution in codon 313 in exon 5.
Subject(s)
HLA-C Antigens , Humans , HLA-C Antigens/genetics , Alleles , Histocompatibility Testing , Sequence Analysis, DNA , Exons/geneticsABSTRACT
HLA-C*03:606 differs from HLA-C*03:03:01:01 by one nucleotide substitution in codon 276 in exon 5.
Subject(s)
HLA-C Antigens , Humans , HLA-C Antigens/genetics , Alleles , Histocompatibility Testing , Sequence Analysis, DNA , Exons/geneticsABSTRACT
HLA-DQA1*01:89 differs from HLA-DQA1*01:01:01:01 by one nucleotide substitution in codon -5 in exon 1.
Subject(s)
Alleles , Humans , HLA-DQ alpha-Chains/genetics , Sequence Analysis, DNA , Exons/geneticsABSTRACT
HLA-C*12:354 differs from HLA-C*12:03:01:01 by one nucleotide substitution in codon 240 in exon 4.
Subject(s)
HLA-C Antigens , Alleles , Exons/genetics , HLA-C Antigens/genetics , Histocompatibility Testing , Humans , Sequence Analysis, DNAABSTRACT
HLA-DQB1*02:197 differs from HLA-DQB1*02:01:01:01 by one nucleotide substitution in codon 18 in exon 2.
Subject(s)
Alleles , HLA-DQ beta-Chains/genetics , Histocompatibility Testing , Humans , Sequence Analysis, DNAABSTRACT
BACKGROUND: Highly sensitized (HS) anti-HLA patients awaiting kidney transplantation benefit from specific allocation programs. Serological monitoring at 3-mo intervals is recommended to prevent unexpected positive crossmatch (XM), but this strategy is not evidence-based. Therefore, we assessed its relevance when using single-antigen flow bead (SAFB) and screening flow bead (SFB) assays. METHODS: We included 166 HS patients awaiting a transplant and assessed their SAFB profile during the year preceding their inclusion. Anti-HLA antibodies were evaluated by SAFB assay and compared within patients as serum pairs at 3, 6, and 9 mo. We assessed the performance of SFB for detecting changes in SAFB profiles with 35 serum pairs. RESULTS: On comparing 354, 218, and 107 serum pairs at 3, 6, and 9 mo, respectively, only 0.6%, 0.7%, and 1% of all antigens tested exceeded for the first time the unacceptable antigen threshold (mean fluorescence intensity ≥2000) in the most recent sample. Irrespective of the follow-up period, the calculated panel-reactive antibodies increased by a mean of 1%, and there was no significant increase in the proportion of donors at risk for positivity of flow- or complement-dependent cytotoxicity XM. The SFB did not accurately detect the variations of SAFB profiles. CONCLUSIONS: Changes in HS patient profiles are anecdotal and show little association with transplant access or risk for positive XM. Less-frequent monitoring in HS patients should be considered to improve cost-effectiveness without affecting transplant safety.