부산대학교 도서관

Background The role of anti- HLA- DP antibodies in renal transplantation is poorly defined. This study describes the impact of donor (donor-specific antibody [ DSA]) and non-donor-specific antibodies against HLA- DP antigens in renal transplant patients. Methods Of 195 consecutive patients transplanted between September 2009 and December 2011, 166 primary kidney recipients and their donors were typed (high-resolution) for DP antigens. Sera taken pre-transplant and at 1, 3, 6, 9, and 12 months, and annually post-transplant were retrospectively tested for anti- DP antibodies using single-antigen beads. Results In 81 (49%) patients, anti- DP antibodies were found; 64% (n=52) of patients were positive in the pre-transplant samples and 36% (n=29) were positive exclusively post-transplant. The median time from transplantation to antibody was 20.9 months. Fifty-five percent (n=16) of the de novo anti- DP antibodies were accompanied by another de novo DSA. Anti- DP antibody-positive patients had a higher rate of rejection (compared with anti- DP antibody-negative patients, P=.01). The estimated glomerular filtration rate declined more with anti- DP antibodies (−5.5% vs +26%). Conclusions Antibodies against HLA- DP antigens are common. De novo anti- DP antibodies commonly appear after acute rejection and accompany DSA, which makes it difficult to determine whether anti- DP antibodies are the cause or the consequence of graft injury. [ABSTRACT FROM AUTHOR]