Serum HLA-G Levels in Kidney Transplant Recipients and Association With Clinical Outcomes: A Single-Center Cross-Sectional Study

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2026-09-01 Epub Date: 2026-05-22 DOI:10.1016/j.transproceed.2026.04.015

Silvia Marçal Botelho, Geovana Maria Nunes Arantes Chaves, Isabela Jubé Wastowski, Antônio Menezes da Silva Júnior

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Abstract

Background

HLA-G is a non-classical HLA class I molecule with immunomodulatory properties and has been proposed as a biomarker of immune tolerance in kidney transplantation. However, the clinical meaning of circulating HLA-G remains controversial.

Methods

We conducted a cross-sectional, single-center study including kidney transplant recipients with available clinical data and serum samples. Soluble HLA-G levels were quantified by enzyme-linked immunosorbent assay. We tested associations between HLA-G levels and immunosuppressive regimen, acute rejection episodes, cytomegalovirus (CMV) infection, and early post-transplant need for hemodialysis. Statistical significance was defined as P < .05.

Results

A total of 114 kidney transplant recipients were analyzed. Use of a regimen including corticosteroids, a calcineurin inhibitor, and azathioprine was associated with lower HLA-G levels (P < .001). Lower HLA-G levels were also associated with acute rejection (P < .001) and CMV infection (P = .006). In contrast, recipients requiring 6–10 hemodialysis sessions in the early post-transplant period showed higher HLA-G levels (P = .02).

Conclusions

Serum HLA-G levels were significantly associated with clinically relevant outcomes after kidney transplantation. Lower HLA-G levels were linked to acute rejection and CMV infection, whereas higher HLA-G levels were observed among recipients requiring more hemodialysis early after transplantation. These findings support further evaluation of HLA-G as a prognostic biomarker.

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肾移植受者血清HLA-G水平及其与临床结果的关系：一项单中心横断面研究

背景：HLA- g是一种具有免疫调节特性的非经典HLA I类分子，已被提出作为肾移植免疫耐受的生物标志物。然而，循环HLA-G的临床意义仍然存在争议。方法：我们进行了一项横断面、单中心研究，包括有临床资料和血清样本的肾移植受者。酶联免疫吸附法测定可溶性HLA-G水平。我们测试了HLA-G水平与免疫抑制方案、急性排斥反应、巨细胞病毒（CMV）感染和移植后早期血液透析需求之间的关系。统计学意义定义为P < 0.05。结果：对114例肾移植受者进行分析。使用包括皮质类固醇、钙调磷酸酶抑制剂和硫唑嘌呤在内的治疗方案与较低的HLA-G水平相关（P < 0.001）。低HLA-G水平也与急性排斥反应（P < 0.001）和巨细胞病毒感染（P = 0.006）相关。相比之下，在移植后早期需要6-10次血液透析的受者显示出更高的HLA-G水平（P = 0.02）。结论：血清HLA-G水平与肾移植术后临床相关结果显著相关。较低的HLA-G水平与急性排斥反应和巨细胞病毒感染有关，而在移植后早期需要更多血液透析的受者中观察到较高的HLA-G水平。这些发现支持进一步评估HLA-G作为预后生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.