Human leukocyte antigen-G (HLA-G) is a tolerogenic protein shown to contribute to allograft survival. Dimerized, soluble HLA-G (sHLA-Gd) has been shown to significantly prolong allograft survival and correlate with reduced levels of pro-inflammatory cytokines. Our goal was to determine if subject's sHLA-Gd levels correlate with patient demographics, allowing clinicians to better predict a patient's immunogenicity and likelihood of rejecting a transplanted organ. Blood samples collected from 122 renal transplant recipients, with no history of rejection (NR, n=90) or with a history of biopsy confirmed acute cellular rejection (ACR, n=32), were analyzed by immunoprecipitation and western blot. The sHLA-Gd level was determined and categorized based on participant's rejection status, gender, ethnicity, age, cause of end-stage renal disease, type of transplant donor, number of Class I and Class II HLA mismatches, as well as class I and class II panel reactive antibody (PRA) levels. Our data show sHLA-Gd levels are significantly higher (p=0.0015) in NR than ACR. Higher sHLA-Gd levels were found in NR than ACR females (p=0.006), African-Americans (p=0.0039), Caucasians (p=0.0067), deceased-donor transplants (p=0.0166), living-donor transplants (p=0.0293), and those with Glomerular Disease (p=0.0058) or Polycystic Kidney Disease (p=0.0229). No significant difference in sHLA-Gd levels were found between NR and ACR males or those with diabetes mellitus or hypertension. Higher sHLA-Gd levels are correlated with better class I and class II HLA matches between donors and recipients. Moreover, lower class I PRA and class II PRA correlated with high sHLA-Gd levels. Data demonstrates that higher sHLA-Gd levels correlate with prolonged allograft survival in most demographic populations. sHLA-Gd is an agent which modulates the allogenic and inflammatory response, serving as a biomarker for immunogenicity. Measuring sHLA-Gd levels may assist clinicians in tailoring immunosuppression regimens to effectively improve renal allograft survival in patient with differing degrees of immunogenicity. Supported by the Carlos and Marguerite Mason Trust and the Medical College of Georgia's Medical Scholars Program.

CITATION INFORMATION: Callaway C, Ajith A, Portik-Dobos V, Best P, Zayas C, Kapoor R, Horuzsko A, Mulloy L. Soluble Human Leukocyte Antigen-G Levels and Prolonged Allograft Survival: A Demographic Analysis. Am J Transplant. 2017;17 (suppl 3).

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