Human neutrophil antigen-3 allele mismatching among kidney transplant patients with rejection

  • Pyae Mon Kyaw Medical Technology Program, Faculty of Associated Medical Sciences, Khon Kaen University
  • Chitranon Chan-on Internal Medicine Department, Faculty of Medicine, Khon Kaen University
  • Chanvit Leelayuwat Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University
  • Amornrat Romphruk Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University
  • Piyapong Simtong Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University
Keywords: Graft rejection, Antibody mediated rejection, Kidney transplantation, Human neutrophil antigen



Introduction: To date, the study of HNA-3 genotype mismatching in kidney-transplant patients with antibody-mediated rejection (AMR) has not been reported. Objective: To determine the extent of HNA-3 genotype mismatching and to estimate the risk of HNA-3 alloimmunization and also detect anti-HNA-3 antibodies among kidney-transplant patients with AMR. Materials and Methods: Ninety pairs of recipients and the corresponding donors were genotyped for the HNA-3 system and an HNA-3a variant (C451T) by polymerase chain reaction using sequence-specific primers (PCR-SSP). HNA-3 antibodies were investigated using the granulocyte agglutination test (GAT) and the LabScreen Multi HNA kit. Results: Patients with AMR had frequencies of HNA-3a/3a, HNA-3a/3b and HNA-3b/3b of 0.567, 0.355 and 0.078, respectively, while the frequencies in the corresponding donors were 0.556, 0.433 and 0.011, respectively. The risk of alloimmunization for HNA-3a was 0.072. HNA-3a incompatibility was found in 21% and HNA-3b in 79%. No AMR patients exhibited HNA-3a and HNA-3b antibodies. However, patients with AMR due to HLA-class I and/or class II antibodies were found. Conclusion: Our data provide evidence that the chance of HNA-3 incompatibility in kidney-transplant recipients is high (36.7% in this study) despite which, HNA-3a antibodies were not detected. Taken together, these findings indicate that HNA-3a antibodies are less important for the pathomechanism of kidney transplant rejection.


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นิพนธ์ต้นฉบับ (Original article)