HLA antibodies in renal transplant candidates
Lenhartová, E.; Lenhart, K.; Bártová, A.; Loucková, I.
Acta Universitatis Palackianae Olomucensis Facultatis Medicae 134: 81-83
1992
ISSN/ISBN: 0301-2514 PMID: 1364974 Document Number: 397474
The level of anti-HLA antibodies was followed in 155 patients of the chronic dialyzed program: against antigens HLA Class I and antigens HLA-DR representing HLA Class II. Correlation between the titre of these antibodies and additional factors were analyzed. The effect of pregnancy and consequently of sex was proved. Of significance were the number of dialysis undergone and the time of inclusion into the dialyses program. Positive correlation between the titre of both types of anti-HLA antibodies is so significant that it makes possible to concentrate on the more simple anti HLA I antibodies determination. The result of crossmatch test is of crucial importance when making decisions on suitable recipient of the kidney from the set of patients of dialyzed program (DP)-1,2,3,4. The presence of anti-HLA alloantibodies can cause hyperacute rejection-5,6,7,8,9. The anti-HLA alloantibodies titre is regularly followed in DP patients. Several significant hypotheses can be verified in a large enough set of patients (hypotheses marked with ordinal numbers 1-5): 1. Only the titre of anti-HLA Class I antibodies is usually followed in DP patients. Some worksplaces abroad consider it useful to follow even the anti-HLA Class II antibodies-10,1,1,1,2. Is anti-HLA I and HLA II antibodies titre in such a significant correlation that it is sufficient to follow only anti-HLA Class I? 2. Mechanisms of HLA antigen sensitization in DP patients are well known-13,14,15. We can verify the influence of transfuison number, allograft rejections and number of previous pregnancies on the anti-HLA antibodies titre. 3. It is also known that non-specific sensitization can influence the antibodies formation both in positive and negative ways-16,17,18. We determined the influence of HbSAg presence on the anti HLA antibodies formation. 4. Influence of additional factors on antibodies formation, such as the patient sex, his age, blood group, primary disease and how long he has been in the DP set-19,20,21. The effect of these factors was verified in our set of patients. 5. The individuals with HLA DRw6 are classified by some authors as the non-responders-22,23,24. The hypothesis on more significant HLA-DRw6 immunogenity could explain the matter of the non-responders.