Kidney Week

Abstract: FR-PO891

High Level of HLA-DP Expression in Kidney Donors Is Associated with a Reduced Graft Survival

Session Information

• Transplantation: Translational and Transplant Pathology
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1802 Transplantation: Clinical

Authors

• Heinzel, Andreas, Medical University of Vienna, Vienna, Vienna, Austria

Andreas Heinzel,

• Reindl-Schwaighofer, Roman, Medical University of Vienna, Vienna, Vienna, Austria

Roman Reindl-Schwaighofer,

• Kainz, Alexander, Medical University of Vienna, Vienna, Vienna, Austria

Alexander Kainz,

• Jelencsics, Kira, Medical University of Vienna, Vienna, Vienna, Austria

Kira Jelencsics,

• Hu, Karin, Medical University of Vienna, Vienna, Vienna, Austria

Karin Hu,

• Hruba, Petra, Institute for Clinical and Experimental Medicine, Department of Nephrology, Prague, Czechia

Petra Hruba,

• Viklicky, Ondrej, Institute for Clinical and Experimental Medicine, Department of Nephrology, Prague, Czechia

Ondrej Viklicky,

• Bohmig, Georg, Medical University of Vienna, Vienna, Vienna, Austria

Georg Bohmig,

• Keating, Brendan, University of Pennsylvania, Philadelphia, Pennsylvania, United States

Brendan Keating,

• Oberbauer, Rainer, Medical University of Vienna, Vienna, Vienna, Austria

Rainer Oberbauer,

Background

HLA-DP mismatch between kidney allograft donors and recipients has increasingly been recognized as risk factor for adverse long-term outcome following transplantation. Current matching algorithms do not account for HLA-DP mismatch. The single nucleotide variant rs9277534 in the 3′ UTR of DPB1 is associated with HLA-DPB1 expression levels.

Methods

We made use of the iGeneTrain consortium and genotyped 477 first kidney transplant recipients and respective deceased donors from two centers in Vienna and Prague. HLA eplet mismatch was calculated for the HLA-A, -B, -C, -DP, -DQ, and -DR loci.

The median follow-up time of the cohort was 6.5 years. Kaplan-Meier analysis and a Cox PH model were used to assess the association of rs9277534 with death censored graft loss.

Results

The rs9277534 variant influencing HLA-DPB1 expression levels is associated with graft loss after kidney transplantation. Kaplan-Meier analysis (figure 1) showed that presence of one or two copies of a ‘G’ allele at rs9277534 in the donor was associated with an elevated risk for graft loss. This association remained significant in a multivariable Cox model after adjustment for donor age and full HLA eplet mismatch (HR of rs9277534: 2.05 CI: 1.15 – 3.67).

Conclusion

Presence of the high expression variant in kidney allograft donors is associated with a reduced graft survival.

Figure 1: KM plot relating kidney allograft donor status of the rs9277534 variant influencing HLA-DPB1 expression with death censored graft loss after transplantation.