HLA Mismatching and Subclinical Inflammation: An Association to be Considered in Kidney Transplant Patients with Low Immunological Risk

T. Vazquez-Sanchez¹, J. Alonso-Titos¹, P. Ruiz-Esteban¹, A. Caballero², M. Leon³, V. Lopez¹, E. Sola¹, D. Hernández¹

¹Nephrology, Instituto de Investigación Biomédica de Málaga (IBIMA). Hospital Universitario Regional de Málaga and University of Málaga. REDinREN (RD16/0009/0006). Málaga. (Spain), Málaga, Spain, ²Immunology, Instituto de Investigación Biomédica de Málaga (IBIMA). Hospital Universitario Regional de Málaga and University of Málaga. REDinREN (RD16/0009/0006). Málaga. (Spain), Málaga, Spain, ³Pathology, Instituto de Investigación Biomédica de Málaga (IBIMA). Hospital Universitario Regional de Málaga and University of Málaga. REDinREN (RD16/0009/0006). Málaga. (Spain), Málaga, Spain

Meeting: 2021 American Transplant Congress

Abstract number: 581

Keywords: Graft survival, Histocompatibility, Inflammation, Kidney transplantation

Topic: Basic Science » Histocompatibility and Immunogenetics

Session Information

Session Name: Histocompatibility and Immunogenetics

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: Subclinical inflammation (SCI) (2+i₂Banff Classification) is a very common histological finding in kidney transplants (KT) (± 40-60%) with modern immunosuppression. Its influence in reducing long-term graft survival is known. Our aim is to analyze whether HLA mismatching is associated with the risk of suffering from SCI.

*Methods: As a part of clinical Trial NCT02284464, we collected the protocol biopsy results at third month after KT in 105 patients with low immunological risk. We evaluated the histological findings according to the Banff 17 classification. We divided them in Group I (n=51), with no inflammation (NI) and Group II (n=54) with SCI. We analyzed the HLA-histocompatibility between donor and recipient with PCR-SSP. We determined A, B, C, DR and DQ alleles.

*Results: Most of the patients were male and the donor mean age was 52 years old in Group I and 55 in Group II. There were no differences in the time in dialysis, cold ischemia time, induction therapy, tacrolimus levels, pretransplant PRA or the delayed graft function (DGF). We found that those who had SCI had a worse graft function and more chronic lesions than the NI group (ct+ci+cg+cv 1.6±1.2 vs 0.76±1.03 p=0.001). Group II had more HLA mismatching than Group I.62.5% of the patients who presented with NI had less than or equal to 6 HLA-incompatibilities. 61.5% of those with SCI had more than 6 HLA-incompatibilities.$$table1


	NI (n=51)	SCI (n=54)	p
Donor age (years)	52.4±13.4	55±11.8	0.311
Expanded criteria donor (%)	36	49,1	0,181
Recipient BMI (kg/m²)	27.4±3.9	25.7±4.3	0.094
Male (%)	72.5	74.1	0.860
Hemodialysis (%)	72	64,8	0.686
Time in dialysis (months)	24.3±17.5	19.3±1.1	0.182
Induction therapy (%)	53.9	90.2	0.270
Cold ischemia time (h)	10.6±6.7	10.8±6	0.877
Pretransplant PRA (%)	0,43±2.7	0	0.323
DGF (%)	24	26.9	0.735
Tacrolimus levels (ng/ml)	9.7±2.9	9.2±2.1	0.286
HLA mismatches (n) (A,B,C,DR,DQ)	5.4±2.4	6.9±2	0.002
Proteinuria (mg/dl)	297.4±229.4	278.9±224.9	0.763
MDRD-4 (ml/min)	60±23.4	48.5±13.6	0.003

*Conclusions: We highlight the importance of HLA mismatching in patients with low immunological risk and the assessment in the induction therapy as well as in the maintenance immunosuppression.

To cite this abstract in AMA style:

Vazquez-Sanchez T, Alonso-Titos J, Ruiz-Esteban P, Caballero A, Leon M, Lopez V, Sola E, Hernández D. HLA Mismatching and Subclinical Inflammation: An Association to be Considered in Kidney Transplant Patients with Low Immunological Risk [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/hla-mismatching-and-subclinical-inflammation-an-association-to-be-considered-in-kidney-transplant-patients-with-low-immunological-risk/. Accessed May 16, 2025.

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