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Abstract: SA-PO1050

DQB1 Mismatch in Living Donor Kidney Transplantation

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical


  • Charnaya, Olga, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Ishaque, Tanveen, NYU Langone Health, New York, New York, United States
  • Schmitz, John, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
  • Timofeeva, Olga A., Georgetown University, Washington, District of Columbia, United States
  • Lazar-Molnar, Eszter, University of Utah Health, Salt Lake City, Utah, United States
  • Morris, Gerald P., University of California San Diego, La Jolla, California, United States
  • Coppage, Myra, University of Rochester, Rochester, New York, United States
  • Krummey, Scott M., The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Hidalgo, Luis G., University of Wisconsin System, Madison, Wisconsin, United States
  • Zhang, Aiwen, Cleveland Clinic, Cleveland, Ohio, United States
  • Segev, Dorry L., NYU Langone Health, New York, New York, United States
  • Tambur, Anat R., Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Massie, Allan, NYU Langone Health, New York, New York, United States

Several studies have reported an association between HLA-DQ mismatch, and formation of dnDSA and ABMR. Given the notable linkage in inheritance of HLA- DR and -DQ, we sought to determine what additional benefit can be gained by adding DQB1 allele matching to predicting allograft outcome.


We included living donor kidney transplant recipients (N=3886) transplanted between 2010-2022. Clinical, demographic, and outcome data were obtained from SRTR. HLA DQB1 allele typing and DR antigen was provided by each center. Using multivariable Cox-proportional hazards models we evaluated the hazard (aHR) of graft failure with level of DR and DQB1 mismatching. We used AIC to evaluate which model provide the best fit.


In an unadjusted model, DQB1 allele mismatching was not associated with an increased hazard of death-censored graft failure (DCGF). In adjusted models, both DQB1 and DR were independently associated with increased hazard of DCGF aHR per mismatch 1.2 (1.01, 1.44) and 1.21 (1.02, 1.45), respectively. When both DR and DQB1 are in the model, neither is statistically significant. The model with DQ+DR provided best fit, although the difference was not statistically significant (delta-AIC<2).


Despite a strong association between DQB1 mismatching and dnDSA/ABMR, its' addition to matching algorithms in living donor recipients when considering DCGF may not provide added benefit over DR matching, likely due to the strong linkage disequilibrium between these two loci.