Background. The lectin pathway of complement activation and its major recognition molecule mannose binding lectin (MBL) may play an important role in immune damages after solid organ transplantation (SOT). Genetic polymorphisms in mbl2 leading to low levels of functional MBL have been associated with increased risk of infections. The role of recipient MBL on rejection is less well documented. Here we analyzed the association between MBL polymorphisms and graft outcome after SOT. Methods. The Swiss Transplant Cohort Study is a prospective muticenter cohort of all SOT recipients since 2008. We analyzed all biopsy-proven rejections based on histology scores. Functional MBL levels were determined in serum samples and DNA obtained for genotyping using a custom-made Illumina Golden Gate Genotyping assay on Beadxpress® and SNP specific PCR for 6 MBL2 polymorphisms (rs11003125, rs1800450, rs1800451, rs5030737, rs7096206, rs709589). Associations were assessed by cumulative incidence charts and Cox regression models. Results. The study included 1174 SOT recipients (kidney=809, liver=153, lung=109, heart=83, other=20), among whom 1046 Caucasians had MBL genotypes. When all patients were analyzed together, MBL levels did not influence the risk of acute cellular rejection (ACR, P=0.7). However when patients were stratified by organs, different effects were observed. In kidney recipients, low MBL levels (<median) and deficient diplotypes were associated with a higher risk of ACR (P=0.02 and P=0.03). This association was still significant (HR=1.47, 95% CI, p=0.02) in a Cox regression model after adjustment for relevant covariates. In non-kidney recipients, low MBL levels and deficient diplotypes tended towards a lower risk of ACR although without reaching the level of significance (P=0.08 and P=0.13). MBL levels did not correlate with antibody-mediated rejections. Conclusion. Using a large prospective cohort we observed organ-specific effects of MBL polymorphisms which may lead to individual risk stratification and customized immunosuppression.
To cite this abstract in AMA style:Golshayan D, Wojtowicz A, Manuel O, Bibert S, Pascual M, Meylan P, Bochud P. Role of Mannose Binding Lectin on the Incidence of Rejection after Kidney and Other Solid Organ Transplantation [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/role-of-mannose-binding-lectin-on-the-incidence-of-rejection-after-kidney-and-other-solid-organ-transplantation/. Accessed May 6, 2021.
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