Korean J Transplant.  2021 Oct;35(Supple 1):S64. 10.4285/ATW2021.PO-1124.

Association of preoperative non-HLA antibodies with kidney allograft rejection

• Oh I
• Park S
• Jung K
• Lee H
• Song EY

• KMID: 2521412
• DOI: http://doi.org/10.4285/ATW2021.PO-1124

Abstract

Background
Non-human leukocyte antigen (HLA) antibodies are thought to have an impact on kidney allograft rejection. We analyzed the titers of non-HLA antibodies in kidney transplant recipients at the time of transplantation and screened which antibodies are associated with kidney allograft rejection.
Methods
The study included 400 preoperative sera from kidney transplant recipients with biopsy-proven antibody-mediated rejection (ABMR, n=47), T-cell mediated rejection (TCMR, n=200), and controls without rejection (n=153) at Seoul National University Hospital between 2015 and 2021. A total of 41 types of non-HLA antibodies were analyzed by Luminex method (Labscreen Autoantibody and Labscreen Mixed, One Lambda, USA) and enzyme immunoassay (EIA-AT1RX, One Lambda, USA). In multivariable logistic regression analysis, the effect of DSA and HLA mismatch are adjusted.
Results
In multivariable analysis, occurrence of ABMR was related to the increase of anti-collagen type I (≥75 percentile val-ue provided by the manufacturer, odds ratio [OR], 10.6; P=0.001) and the increase of anti-collagen type IV antibody (OR, 2.3; P=0.033). The occurrence of ABMR was decreased with the increase of anti-ARHGDIB (OR, 0.4; P=0.007), anti-collagen II (OR, 0.3; P=0.001) and anti-LG3 (OR, 0.3; P=0.015). Meanwhile, the occurrence of TCMR was associated with the increase of anti-collagen II antibody (OR, 2.1; P=0.007).
Conclusions
The increase of anti-collagen type I and type IV antibody titers at the time of transplantation was related to ABMR of kidney allografts. The increase of anti-ARHGDIB, anti-collagen II, and anti-LG3 antibody titers was related to the decreased occurrence of ABMR. Anti-collagen II antibody was related to the occurrence of TCMR. Further researches are needed on the mechanism by which each antibody acts in the rejection of kidney allografts.