Human immunology · 2026
Characterization of anti-HLA antibodies pre- and post-renal transplantation in the Tunisian central region.
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Changuel Maha, Bannour Ichrak, Elghali Mourad, Mahmoud Nouha Ben, Chouat Hadhom, Jaafar Ines, Aissi Wafa, Hamouda Mouna, Skhiri Habib, Sakly Nabil
Аннотация
BACKGROUND: In kidney transplantation, anti-HLA antibodies are associated with poor graft outcomes. This study aimed to describe the profile of anti-HLA antibodies in both renal transplanted patients and patients awaiting transplantation and to assess their impact on graft outcomes in the Tunisian central coastal region.
METHODS: We retrospectively analyzed the results of anti-HLA antibody determination in 191 patients (31 transplanted and 160 awaiting transplantation) recruited between January 2019 and October 2024. Anti-HLA antibodies were investigated, prior and after a kidney transplantation if any, at the Immunology Laboratory of the University Hospital of Monastir, using Luminex technology in two steps: screening and single antigen typing.
RESULTS: Among the 191 patients evaluated before transplantation, 31.4 % (60/191) had anti-HLA antibodies, and 12.9 % (4/31) developed de novo antibodies after transplantation. Among the sensitized individuals, 92.2 % had anti-HLA class I antibodies, 54.7 % had class II antibodies, and 46.9 % had antibodies against both classes. The most frequent specificities were anti-HLA A2, A25, B44, B45, DQ7, and DR17. Sensitization was significantly associated with a history of blood transfusion (42.0 %; p = 0.036). High immunization levels (cPRA > 80 %) were observed in 24.5 % of patients with class I antibodies and 29 % with class II antibodies, while high Mean Fluorescence Intensity (MFI > 10,000) were detected in 38.9 % and 58.1 % of class I and class II cases, respectively. After transplantation, de novo developed antibodies were non-donor-specific antibodies, except for one. Graft rejection occurred in four patients (12.9 %), comprising three acute cellular rejections and one chronic rejection.
CONCLUSION: In summary, our study confirmed that anti-HLA antibodies are relatively frequent prior to transplantation. They are not associated with antibody-mediated rejection, and the most frequently detected antibody specificities did not correlate with the most prevalent HLA antigens in the Tunisian population.
METHODS: We retrospectively analyzed the results of anti-HLA antibody determination in 191 patients (31 transplanted and 160 awaiting transplantation) recruited between January 2019 and October 2024. Anti-HLA antibodies were investigated, prior and after a kidney transplantation if any, at the Immunology Laboratory of the University Hospital of Monastir, using Luminex technology in two steps: screening and single antigen typing.
RESULTS: Among the 191 patients evaluated before transplantation, 31.4 % (60/191) had anti-HLA antibodies, and 12.9 % (4/31) developed de novo antibodies after transplantation. Among the sensitized individuals, 92.2 % had anti-HLA class I antibodies, 54.7 % had class II antibodies, and 46.9 % had antibodies against both classes. The most frequent specificities were anti-HLA A2, A25, B44, B45, DQ7, and DR17. Sensitization was significantly associated with a history of blood transfusion (42.0 %; p = 0.036). High immunization levels (cPRA > 80 %) were observed in 24.5 % of patients with class I antibodies and 29 % with class II antibodies, while high Mean Fluorescence Intensity (MFI > 10,000) were detected in 38.9 % and 58.1 % of class I and class II cases, respectively. After transplantation, de novo developed antibodies were non-donor-specific antibodies, except for one. Graft rejection occurred in four patients (12.9 %), comprising three acute cellular rejections and one chronic rejection.
CONCLUSION: In summary, our study confirmed that anti-HLA antibodies are relatively frequent prior to transplantation. They are not associated with antibody-mediated rejection, and the most frequently detected antibody specificities did not correlate with the most prevalent HLA antigens in the Tunisian population.