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Correspondence to Author: Shivam Bhujani, Shely Hanish, Michel Carnor, Marus Rusill-Lowe, Juath Worington, Henrey K. L. Wan, Rajkumari Chiladurai, Kalo Poutuon. . 

Department of Renal Medicine, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK.

Abstract:

For eligible patients with end-stage kidney disease (ESKD), kidney transplantation is the recommended form of kidney replacement therapy since it has been shown to lower death rates, enhance quality of life, and be more affordable than dialysis. Although the risk of rejection has decreased due to recent developments in donor-specific antibody (DSA) detection and human leukocyte antigen (HLA) typing, antibody-mediated rejection (AMR) can still happen in the absence of DSA. According to earlier research, antibodies against non-human leukocyte antigens (non-HLAs) may be the cause of rejection.
Our goals were to learn more about the distribution and prevalence of non-HLA antibodies in our community, try to link these results to graft outcomes, and discover whether non-HLA antibodies might be used to identify graft dysfunction and impairment. Methods: From January 2010 to December 2020, we performed a retrospective analysis on kidney transplant recipients. All of the participants were over the age of 18, had received kidney transplants alone, were compatible with both ABO and HLA, and were matched at the A, B, and DR loci (mismatch 0:0:0). At the time of transplantation, HLA testing came out negative.
Using the One Lambda LABScreenTM, Autoantibody kit groups 1, 2, and 3, as well as the Immucor LIFECODES non-HLA autoantibody assay, the samples from the control group and the early graft rejection cases were examined for non-HLA antibodies. Findings: Out of the 850 kidney transplant recipients, 12 developed early graft rejection within the first month following their procedure, and 18 did not. These patients were chosen as study controls. Due to a small sample size, our study found no association between early rejection and the overall burden of non-HLA antibodies. However, a sub-analysis showed that rejection was linked to certain high-frequency pre-transplant non-HLA antibodies identified by LIFECODES, including GSTT, CXCL11, CXCL10, and HNR (Fisher’s exact test with Bonferroni correction, p < 0.001). Following transplantation, the majority of pre-transplant non-HLA antibody levels decreased, which was explained by immunosuppression. Conclusion: Although the overall relationships between the burden of non-HLA antibodies and rejection episodes are still unclear, the “high frequency” non-HLA antibodies showed a correlation with graft rejection. The rebound phenomena of non-HLA antibodies, the long-term generation of de novo non-HLA antibodies, and their effects on graft survival require more research.

Keywords:Snon-human leukocyte antibodies; graft rejection; kidney transplantation

Citation:

Dr.Shivam Bhujani, Evaluating The Clinical Relevance Of Antibodies Againstnon-Human Leukocyte Antigen In Kidney Transplantation. Journal of Antibodies 2025.