The effect of anti-human leukocyte antigen, anti-major histocompatibility complex class 1 chain-related antigen a, and anti-glutathione transferase-T1 antibodies on the long-term survival of renal allograft.

Abstract

Background. One of the most important mechanisms of allograft rejection is the production ofdonor-specific antibodies (DSA). Anti-major histocompatibility complex class-I chain-relatedantigen A (MICA) and anti-glutathione S transferase-T1 (GSTT1) antibodies cause graft dysfunctionand reduce graft survival. The aim of this study was to examine the effects of anti-humanleukocyte antigen class I–II, anti-MICA, and anti-GSTT1 antibodies in development of antibodymediatedrejection.Methods. Among the 32 renal transplant patients included in this study 65% experiencedantibody-mediated rejection (AMR; chronic activeAMR[CAMR], n17; acuteAMR[AAMR],n 4) and 35%, ACR. The anti-HLA class I–II and anti-MICA antibodies were determined byusing LUMINEX, anti-GSTT1 antibodies by enzyme-linked immunosorbent assay. GSTT1genotyping of patients and donors was performed by polymerase chain reaction.Results. Antibody was detected in 19 of 21 patients undergoing antibody-mediated rejection(90%). We detected anti-GSTT1 in 4, anti-MICA in 8, anti-HLA class I in 5, and anti-HLA classII in 9 patients withCAMR(P.007). If the patients were divided into 2 groups according to beingC4d and C4d both anti-HLA class I and class II antibodies were found significantly morefrequently among the C4d group (P .019, P .024). No difference was determined betweenAMR and ACR groups in terms of anti-GSTT1 and anti-MICA antibodies.Conclusions. In this study, we observed the role of anti-HLA class II antibodies in thedevelopment of CAMR and in long-term allograft survival. It is observed that anti-MICA andanti-GSTT1 antibodies showed no effect on rejection mechanisms.