Aim: HLA donor-specific antibodies (DSA) cause antibody-mediated rejection (AMR) and allograft dysfunction. In this study we examined the association between antibodies to self-antigens (non-HLA antibodies) and acute allograft injury in kidney transplant recipients (KTR) in the absence of HLA DSA.
Methods: We analyzed non-HLA antibodies in pre- and post-transplant sera from 17 KTR with biopsy confirmed AMR but no HLA DSA and 27 KTR with stable allograft function.
Results: Five non-HLA antibody specificities that had a significantly higher positive rate were detected in KTR with biopsy confirmed AMR compared to 27 KTR with stable allograft function (Table 1). All non-HLA antibodies were detected in pretransplant sera and persisted post-transplant.
Conclusion: Our findings suggest that the presence of non-HLA antibodies may be associated with a higher risk for AMR and acute kidney allograft dysfunction in the absence of HLA DSA. Non-HLA antibodies may mediate acute allograft injury through activation of complement cascade, endothelial cell activation, and recruitment of inflammatory cells.
