Analysis of the Humoral Immune Response to Human Leukocyte Antigens in Turkish Renal Transplant Candidates and Relationship Between Autoimmune Disorders

Abstract

Background. Pre-transplant sensitization to human leukocyte antigens (HLA) is a risk factor for graft failure. The purpose of the current single-center study was to evaluate humoral immune response to HLA antigens and the possible relationship between anti-HLA antibody titer and autoimmune disorders in renal transplant candidates. Methods. A total of 435 renal transplant candidates were analyzed; 50 sensitized patients were enrolled in this study. The HLA typing was performed by use of enzyme-linked immunoassay combined with Luminex technology. The patients were questioned for clinical evidence of hypothyroidism and systemic lupus erythematosus (SLE) and investigated for anti-nuclear antibody (ANA), anti-double-stranded DNA (anti-dsDNA), anti-thyroglobulin (anti-TG), anti thyroid permddase (anti-TPO) antibodies, and thyroid function tests. Results. Among 50 patients with positive panel reactive antibody, 24 (48%) were positive for class I and negative for class II, 12 (24%) were negative for class I and positive for class II, and 14 (28%) were positive for both classes I and II. The specificities of anti-HLA antibodies-A23, A68, A69, B27, B49, DR6, and DR8-were the most frequent. ANA and anti-dsDNA antibodies were not correlated with either clinical symptoms of SLE or anti-HLA antibody titer of renal transplant candidates. Similarly, anti-TG and anti-TPO antibodies were not correlated with clinical hypothyroidism or anti-HLA antibody titer. Conclusions. Our data have demonstrated the profile of anti-HLA antibodies in patients who were on the renal transplant waiting list in Turkey. The most frequent specificities of anti-HLA antibodies were A23, A68, A69, B27, B49, DR6, and DR8. There was no association between anti-HLA antibody titer and clinical and laboratory evidence of SLE and hypothyroidism.