RT Journal Article
T1 Impact of HLA Mismatching on Early Subclinical Inflammation in Low-Immunological-Risk Kidney Transplant Recipients
A1 Hernández, Domingo
A1 Vázquez, Teresa
A1 Alonso-Titos, Juana
A1 León, Myriam
A1 Caballero, Abelardo
A1 Cobo, María Angeles
A1 Sola, Eugenia
A1 López, Verónica
A1 Ruiz-Esteban, Pedro
A1 Cruzado, Josep María
A1 Sellarés, Joana
A1 Moreso, Francesc
A1 Manonelles, Anna
A1 Torio, Alberto
A1 Cabello, Mercedes
A1 Delgado-Burgos, Juan
A1 Casas, Cristina
A1 Gutiérrez, Elena
A1 Jironda, Cristina
A1 Kanter, Julia
A1 Serón, Daniel
A1 Torres, Armando
K1 Kidney transplantation
K1 HLA compatibility
K1 Subclinical inflammation
K1 Banff criteria
K1 Low-immunological risk
K1 Tacrolimus
K1 Delayed graft function
K1 ROC curve
K1 Biopsy
AB The impact of human leukocyte antigen (HLA)-mismatching on the early appearance of subclinical inflammation (SCI) in low-immunological-risk kidney transplant (KT) recipients is undetermined. We aimed to assess whether HLA-mismatching (A-B-C-DR-DQ) is a risk factor for early SCI. As part of a clinical trial (Clinicaltrials.gov, number NCT02284464), a total of 105 low-immunological-risk KT patients underwent a protocol biopsy on the third month post-KT. As a result, 54 presented SCI, showing a greater number of total HLA-mismatches (p = 0.008) and worse allograft function compared with the no inflammation group (48.5 ± 13.6 vs. 60 ± 23.4 mL/min; p = 0.003). Multiple logistic regression showed that the only risk factor associated with SCI was the total HLA-mismatch score (OR 1.32, 95%CI 1.06-1.64, p = 0.013) or class II HLA mismatching (OR 1.51; 95%CI 1.04-2.19, p = 0.032) after adjusting for confounder variables (recipient age, delayed graft function, transfusion prior KT, and tacrolimus levels). The ROC curve illustrated that the HLA mismatching of six antigens was the optimal value in terms of sensitivity and specificity for predicting the SCI. Finally, a significantly higher proportion of SCI was seen in patients with >6 vs. ≤6 HLA-mismatches (62.3 vs. 37.7%; p = 0.008). HLA compatibility is an independent risk factor associated with early SCI. Thus, transplant physicians should perhaps be more aware of HLA mismatching to reduce these early harmful lesions.
PB MDPI
YR 2021
FD 2021-04-29
LK http://hdl.handle.net/10668/4370
UL http://hdl.handle.net/10668/4370
LA en
NO Hernández D, Vázquez T, Alonso-Titos J, León M, Caballero A, Cobo MA, et al. Impact of HLA Mismatching on Early Subclinical Inflammation in Low-Immunological-Risk Kidney Transplant Recipients. J Clin Med. 2021 Apr 29;10(9):1934.
DS RISalud
RD Apr 17, 2025