Introduction. Complement activating donor specific antibodies may be associated with worse outcomes in a cohort of patients who have undergone HLA-AIT. We looked for differences in renal allograft outcomes in patients with HLA class 1 and class 2 complement activating IgG antibodies.

Methods: We analysed samples from 121 HLA-AIT who had pre-transplant DSA and subsequently underwent direct transplantation.C3d (Immucor) assay was performed at preconditioning/pre-transplant. IgG C3d results were correlated with HLA class and for prediction of rejection and allograft survival.

Results: Of 121 patients,11 had C3d positive IgG DSA for class1 and 31 had C3d positive IgG DSA positive for class 2. 5 patients had C3d IgG DSA positive for both classes. Either class 1 or class 2 C3d positive DSA was not associated with early rejection (p 0..64 and p0.146 respectively). C3d class 1 DSA was not associated with predicting long term graft survival (p 0.1) but class 2 DSA was associated with predicting long term outcome (p 0.001). Discussion: In this cohort of HLA-AIT renal transplants complement activating IgG donor specific antibodies directed against HLA class 2 antigens were associated with worse long term graft survival. This finding need to verified in larger sample and need to include de-novo antibodies.

CITATION INFORMATION: Babu A, Briggs D, Mitchell D, Krishnan N, Higgins R, Daga S. Does HLA Class of Complement Activating Donor Specific Antibodies Matter: Single Centre Retrospective Analysis of Renal Allograft Outcomes. Am J Transplant. 2017;17 (suppl 3).

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