Abstract
We conducted a nested case-control study from a cohort of adult kidney transplant recipients to assess the risk of transplant glomerulopathy (TG) as a function of donor and recipient HLA-DR and -DQ incompatibility at the eplet level. Cases (n=52) were defined as patients diagnosed with transplant glomerulopathy based on biopsies showing glomerular basement membrane duplication without immune complex deposition. Controls (n=104) with a similar follow-up from transplantation were randomly selected from the remaining cohort. HLAMatchmaker was used to ascertain the number of DRB1/3/4/5, DQA1 and DQB1 related eplet mismatches (eplet load). Multivariable conditional logistic regression models demonstrated an increase in the odds of TG (odds ratios [OR] of 2.84 [95% confidence interval (CI): 1.03, 7.84] and 4.62 [95% CI: 1.51, 14.14]) in the presence of 27-43 and >43 HLA-DR+DQ related eplet mismatches versus <27 eplet mismatches, respectively. When the eplet load was modeled as a continuous variable, the OR for TG was 1.25 (95% CI: 1.04, 1.50) for every 10 additional HLA-DR+DQ eplet mismatches. Our study suggests that minimization of HLA-DR+DQ eplet mismatches may decrease the incidence of transplant glomerulopathy diagnosed by indication biopsies. The role of eplet immunogenicity/antigenicity as determinants of allograft outcomes requires further study. In this nested case-control study from a Canadian cohort of adult kidney transplant recipients, the number of HLA-DR and HLA-DQ related eplet mismatches is independently associated with the development of transplant glomerulopathy.
Original language | English (US) |
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Pages (from-to) | 137-148 |
Number of pages | 12 |
Journal | American Journal of Transplantation |
Volume | 15 |
Issue number | 1 |
DOIs | |
State | Published - Jan 1 2015 |
ASJC Scopus subject areas
- Immunology and Allergy
- Transplantation
- Pharmacology (medical)