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Presence of Highly Immunogenic Mismatch Eplets Is Associated with Development of Chronic Active Antibody-Mediated Rejection: A First Report from Japan.

D. Iwami, K. Morita, H. Sasaki, H. Higuchi, Y. Takada, N. Shinohara.

Urology, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.

Meeting: 2016 American Transplant Congress

Abstract number: D22

Keywords: Histocompatibility, HLA matching, Kidney transplantation, Rejection

Session Information

Session Name: Poster Session D: Antibody Mediated Rejection: Session #2

Session Type: Poster Session

Date: Tuesday, June 14, 2016

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Halls C&D

Backgrounds: De novo donor specific antibody (dnDSA) correlates with chronic active antibody-mediated rejection (CAAMR), a major leading cause of graft loss. It will be a great help if we can identify the patients at a high risk of dnDSA development from the viewpoint of histocompatibility. Structure-based matching concept, which can estimate mismatched (MM) eplets based on structural difference of HLA, can predict the risk of development of dnDSA and CAAMR. However, it has not been evaluated in Japanese patients whose diversity in HLA is very limited.

Materials and Methods: We retrospectively studied living related kidney transplant cases (performed between 2008 and 2013) with ascertained donors' and recipients' HLA-A, B, DRB1, and DQB1 with high resolution. Among the cases, the numbers of MM eplets were determined by using an algorithm, HLAMatchmaker ver.3. The relationship between MM eplets property (i.e. total number and respective numbers of MM eplets in each HLA locus) and development of CAAMR was evaluated. In addition, the possession rate of highly immunogenic eplets in HLA-DR or DQ, shown to compose Terasaki's epitopes (Wiebe et al, American Journal of Transplantation, 2014), were compared between the groups.

Results: Fifty-five patients were included in the current study. The patients were divided into CAAMR group (n=8) and control group (n=47). The number of total MM HLA (4.0±0.9 in CAAMR and 4.3±2.0 in control), total MM eplets (32.7±19.7 in CAAMR and 31.3±10.5 in control), DRB1 MM eplets (11.3±4.3 in CAAMR and 11.7±8.0 in control), or DQB1 MM eplets (9.6±8.5 in CAAMR and 8.2±4.6 in control) were not significantly different. The possession rate of highly immunogenic MM eplets was significantly higher in CAAMR group (CAAMR; 77.7%, control; 36.1%, p<0.05 by chi-square test).

Conclusions: The presence of highly immunogenic MM eplets is associated with development of CAAMR.

CITATION INFORMATION: Iwami D, Morita K, Sasaki H, Higuchi H, Takada Y, Shinohara N. Presence of Highly Immunogenic Mismatch Eplets Is Associated with Development of Chronic Active Antibody-Mediated Rejection: A First Report from Japan. Am J Transplant. 2016;16 (suppl 3).

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To cite this abstract in AMA style:

Iwami D, Morita K, Sasaki H, Higuchi H, Takada Y, Shinohara N. Presence of Highly Immunogenic Mismatch Eplets Is Associated with Development of Chronic Active Antibody-Mediated Rejection: A First Report from Japan. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/presence-of-highly-immunogenic-mismatch-eplets-is-associated-with-development-of-chronic-active-antibody-mediated-rejection-a-first-report-from-japan/. Accessed May 9, 2025.

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