HLA-Specific Antibody Profile in Renal Transplant Patients with Systemic LUPUS Erythematosus

Diana Girnita¹, Paul Brailey² and Alin Girnita³, ¹Division of Immunology, Allergy & Rheumatology, University of Cincinnati Medical Center, Cincinnati, OH, ²Transplant Immunology Division, University of Cincinnati Medical Center -Hoxworth Blood Center, cincinnati, OH, Oman, ³Transplant Immunology Division, University of Cincinnati Academic Health Center, Hoxworth Blood Center, Cincinnati, OH

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Antibodies, Lupus, renal disease and transplantation

Session Information

Date: Tuesday, November 10, 2015

Title: Systemic Lupus Erythematosus - Clinical Aspects and Treatment Poster Session III

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: End stage renal disease due to Systemic lupus erytematosus (SLE) is one of the autoimmune disorder leading to renal transplantation. In this single-center study we sought to describe the sensitization profile in renal transplant patients with end stage renal disease due to SLE.

Methods: A retrospective single center analysis in the last ten years revealed 26 renal transplant patients with SLE (20 females and 6 males). This group was matched to a 53 patient control group, without SLE, but matched for gender and age distribution. The detection and specificity of anti-HLA antibody was achieved by single-antigen bead (Luminex) assays. The HLA polymorphism for A, B, C, DRB1, DRB3/4/5, DQB1, DQA1, DPB1 was performed by reverse SSO for intermediate resolution in all patients, while high resolution SBT (Sanger) was used for 12 cases. The auto-crossmatches were performed both by complement-dependent cytotoxicity, and by flowcytometry.

Results: The HLA typing in SLE group has shown a higher (19/26, 73%) prevalence of HLADRB13/4/5 antigens when compared to control group (8/53, 15%, p<0.05). Furthermore, 4 SLE patients (15%) exhibited a positive cytotoxic and flow auto-crossmatch, compared to only 1 (2%) in controls (p<0.01). The distribution of HLA-specific antibody was 20/26 (77%) in SLE versus 18/53 in controls (33%), p<0.01 The class distribution in SLE group was: 19 anti-class I, and 11 anti class II, versus 11 class I and 7 class II in controls. 22 patients in SLE group exhibited anti-HLA antibody towards public epitopes resulting in a calculated PRA > 50%, while 19 SLE patients exhibited anti-HLA antibody towards public epitopes resulting in a calculated PRA > 80%. The control group had a significantly lower proportion of strong antibody towards public epitopes (4/18 and 2/18, respectively, p<0.01).

Conclusion: Renal transplant patients with SLE exhibited a higher prevalence of HLADRB13/4/5 self antigens, and a higher prevalence of positive auto crossmatches and strong HLA antibody towards public epitopes. This might explain their worse transplant outcomes due to higher prevalence of antiHLA antibodies in these patients.

Disclosure: D. Girnita, None; P. Brailey, None; A. Girnita, None.

To cite this abstract in AMA style:

Girnita D, Brailey P, Girnita A. HLA-Specific Antibody Profile in Renal Transplant Patients with Systemic LUPUS Erythematosus [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/hla-specific-antibody-profile-in-renal-transplant-patients-with-systemic-lupus-erythematosus/. Accessed .

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