HLA Alloimmunization According to the Different Immunization Events and Consequences on Access to Kidney Transplantation.

V. Pernin,¹ A. Cros,¹ I. Szwarc,¹ C. Rene,² J.-F. Eliaou,² V. Garrigue,¹ G. Mourad,¹ M. Le Quintrec-Donnette.¹

¹Department Nephrology and Transplantation, CHU Lapeyronie, Montpellier, France
²Department of Immunology, CHU St ELoi, Montpellier, France

Meeting: 2017 American Transplant Congress

Abstract number: C68

Keywords: HLA antibodies, Kidney transplantation, Retransplantation, Sensitization

Session Information

Session Name: Poster Session C: Disparity in Access and Outcomes for Solid Organ Transplantation

Session Type: Poster Session

Date: Monday, May 1, 2017

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

Presentation Time: 6:00pm-7:00pm

Location: Hall D1

Patients awaiting solid organ transplantation may develop anti-HLA antibodies after sensitization events such as transfusions, pregnancies or previous transplantations. The aim of our work was to analyze the effect of the different sensitization events on anti-HLA immunization and on access to kidney transplantation.

We collected data of sera from patients on waiting list between 01/01/2009 and 31/12/2013 exposed to only one type of sensitization event or without sensitization event. Positive sera at screening underwent single-antigen assay to determine the presence of antibodies against HLA A, B, C, DR, DQ, DP loci (positivity if Median Fluorescence Intensity (MFI)>1000). Accessibility to transplantation was evaluated with calculated panel reactive antibodies (cPRA) and mean waiting time before transplantation.

461 patients were enrolled: 123 patients with transfusions, 68 with pregnancies, 19 with previous transplants and 251 patients without sensitization event (control group). Class I antibodies were detected in 41.5%, 39%, 59.4% and 89.4 % of the control, transfusion, pregnancy and previous transplantation groups respectively (p<0.0001). Class II antibodies were detected respectively in 26.2%, 25.2%, 43.4% and 83.3% (p<0.001). Mean number of specificities (class I and II) was 1.6 ; 2.2 ; 8.5 and 27.4 respectively (p=0.001). Mean MFI were 2385+1931; 2245+1729; 3036+3375; 5697+4784 (p=0.001) and Mean cPRA were 10%, 12%, 35% and 65% respectively (p=0.001). Percentage of patients who had access to transplantation at the end of the follow-up (01/05/2016) was 89.2%, 85.3%, 85.5% and 47.4% respectively (p<0.0001) and the mean waiting time (months) was 20.3+16.0, 23.6+18.7, 24.8+18.2 and 29.1+20.3 respectively (p<0.001).

Anti-HLA immunization risk clearly depends on the sensitization event. Previous transfusions in naïve patients had no impact on anti-HLA immunization. Previous transplantations had the highest effect and significantly restricted the access to a new kidney transplant.

CITATION INFORMATION: Pernin V, Cros A, Szwarc I, Rene C, Eliaou J.-F, Garrigue V, Mourad G, Le Quintrec-Donnette M. HLA Alloimmunization According to the Different Immunization Events and Consequences on Access to Kidney Transplantation. Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Pernin V, Cros A, Szwarc I, Rene C, Eliaou J-F, Garrigue V, Mourad G, Quintrec-Donnette MLe. HLA Alloimmunization According to the Different Immunization Events and Consequences on Access to Kidney Transplantation. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/hla-alloimmunization-according-to-the-different-immunization-events-and-consequences-on-access-to-kidney-transplantation/. Accessed November 22, 2024.

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