Transplant immunology最新文献

{"title":"Transplant outcomes after de novo donor specific antibody (DSA) development correlate with persistence of DSA","authors":"A. Jaffer ,&nbsp;O. Shaw ,&nbsp;D. Stringer ,&nbsp;A. Dorling ,&nbsp;S. Shah","doi":"10.1016/j.trim.2025.102312","DOIUrl":"10.1016/j.trim.2025.102312","url":null,"abstract":"<div><h3>Background</h3><div>The OuTSMART trial confirmed <em>de novo</em> DSAs were associated with an increased risk of graft loss and rejection. In this post-hoc analysis, outcomes were analysed in 132 patients who had a DSA at the point of randomisation and compared between patients who had persistent DSA (DSA+/+) with those in whom the DSA was not detected on subsequent samples (DSA+/−).</div></div><div><h3>Methods</h3><div>Serial serum samples were collected post-enrolment until 2016. Those who had their final visit after 2018, had repeat HLA antibody testing ≥32 months post-randomisation. 115 of the 132 DSA+ patients had 2 or more samples available for analysis. 39/115 patients were persistently DSA+ and in 76/115 the DSA became undetectable at 12–32 months post enrolment.</div></div><div><h3>Results</h3><div>Both groups were well matched in sex, ethnicity, immunosuppression, and DSA status at transplant. The total Mean Fluorescence Intensity (MFI) of baseline DSA was significantly higher in the DSA+/+ <em>vs</em> DSA+/− (11,568 v 6518, <em>P</em> &lt; 0.01) with a predominance of class II HLA. Significantly higher rates of antibody mediated rejection (ABMR) and death censored graft failure (GF) were seen in DSA+/+ <em>vs</em> in DSA+/− (15.4 % v 2.6 %, <em>P</em> = 0.02 and 20.5 % v 6.6 %, <em>P</em> = 0.03 respectively). In Cox regression analysis, persistent DSA and having both HLA classes were associated with increased risk of ABMR (HR 6.05, CI 1.2–30.0, P = 0.03 and HR 14.7, CI 1.33–162, P = 0.03 respectively). Additionally, persistent DSA was associated with higher GF rates (HR 3.4, 1.1–10.4, P = 0.03).</div></div><div><h3>Conclusions</h3><div>Persistent <em>de novo</em> DSA, after kidney transplantation, is associated with higher MFI and increased risk of ABMR and GF.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102312"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Macrophage activation via the NTPDase1-adenosine pathway and associated injury in acute antibody-mediated rejection","authors":"Pu Yan ,&nbsp;Yong Zhang ,&nbsp;Zhongbao Zhou ,&nbsp;Yongjin Huang ,&nbsp;Peng Xue ,&nbsp;Xiaoyan Wang","doi":"10.1016/j.trim.2025.102302","DOIUrl":"10.1016/j.trim.2025.102302","url":null,"abstract":"<div><h3>Background</h3><div>Nucleoside triphosphate diphosphohydrolase 1 (NTPDase1) is a calcium- and magnesium-dependent nucleoside triphosphate diphosphohydrolase. NTPDase1, expressed in mature immune cells to hydrolyze ATP and ADP into adenosine. The NTPDase1and its function in an adenosine pathway plays an important role in suppressing inflammation, immune responses, cell proliferation, and other processes. We investigated the effects and mechanisms of macrophage activation through the NTPDase1-adenosine pathway and the resulting damage from acute antibody-mediated rejection (AMR).</div></div><div><h3>Methods</h3><div>We established an acute AMR skin-graft model by transplanting MHC-mismatched B10.A ear skin onto BALB/c nude mice and inducing rejection with 100 μg anti-H-2Kk IgG. Mice were grouped as wild-type, NTPDase1-knockout, and NTPDase1-overexpression, with isotype-IgG controls. Outcomes were compared across groups, and statistical analyses were performed using SPSS 16.0.</div></div><div><h3>Results</h3><div>After the onset of acute AMR, higher NTPDase1 expression in B cells and grafted skin was associated with lower concentration of extracellular ADP, a reduced proportion of CD68+ macrophages, and milder pathological injury in nude mice, and each parameter showing a negative correlation. At 30 min after AMR onset, CD68 + TNF-α + M1 macrophages predominated, whereas CD68 + CD163+ M2 macrophage numbers did not change significantly. Over time, M1 macrophages progressively decreased, and M2 macrophages became increasingly prominent. By day 7 after AMR onset, compared with controls, CD163+ M2 macrophages and the expression of TGF-β1, vimentin, and α-SMA were significantly increased, whereas the epithelial marker E-cadherin was significantly decreased.</div></div><div><h3>Conclusion</h3><div>NTPDase1 constrains acute AMR by limiting extracellular ADP, curbing macrophage expansion, and reducing graft injury. Transgenic overexpression sustained expression, moderated M1-to-M2 dynamics, and attenuated C4d and fibrotic markers, whereas knockout intensified purinergic signaling, inflammation, and fibrosis. Findings position NTPDase1 as a protective regulator and therapeutic target in AMR.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102302"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting CD38 to reduce anti-HLA antibody levels: A new and effective option to be integrated into desensitization protocols?","authors":"Viola Chiavetta ,&nbsp;Martina Soldarini ,&nbsp;Anna Maria Cafro ,&nbsp;Paola Bertazzoni ,&nbsp;Giuliana Lando ,&nbsp;Giulia Di Maggio ,&nbsp;Tiziana Sole ,&nbsp;Maria Luisa Pioltelli ,&nbsp;Irene Cuppari ,&nbsp;Alessandro Corso ,&nbsp;Adela Sulejmani ,&nbsp;Roberto Cairoli ,&nbsp;Elisabetta Volpato ,&nbsp;Roberto Crocchiolo","doi":"10.1016/j.trim.2025.102323","DOIUrl":"10.1016/j.trim.2025.102323","url":null,"abstract":"<div><div>Desensitization protocols are employed in patients with antibody-mediated organ rejection or hematopoietic stem cell (HSC) transplant recipients from ´HLA-mismatched´ donors with donor-specific antibodies (DSA). However, these protocols sometimes have limitations in effectively reducing anti-HLA antibody levels and maintaining this reduction over time. As a result, there is an ongoing search for new, effective therapies to implement current protocols, involving anti-CD20, bortezomib, and plasma exchange. This case report explores the impact of daratumumab, a well-known anti-CD38 antibody used in the treatment of multiple myeloma, on a patient enrolled in a prospective observational study MyTH (“(My)eloma (T)herapy vs. Anti-(H)LA antibodies”). The patient has been treated since 2021 and follow-up data are presented here, showing a correlation between the kinetics of daratumumab administration and the MFI levels of an anti-HLA antibody against DR12 (baseline MFI of 3,890). These data support the role of anti-CD38 in reducing anti-HLA antibody synthesis.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102323"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics, risk factors, and treatment outcomes of tuberculosis in recipients of solid organ or hematopoietic stem cell transplantation","authors":"Fuyan Shu ,&nbsp;Ping Yuan ,&nbsp;Guohui Zhu ,&nbsp;Jiao Li ,&nbsp;Xiaoqin Xie ,&nbsp;Jian Sheng ,&nbsp;Qiuping Sun ,&nbsp;Mengyao Xiao ,&nbsp;Shenjie Tang ,&nbsp;Ming Yang","doi":"10.1016/j.trim.2025.102322","DOIUrl":"10.1016/j.trim.2025.102322","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis (TB) is one of the most severe complications following organ and tissue transplantation. Early detection and prompt initiation of anti-TB therapy are therefore essential to reduce mortality among transplant recipients.</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis was conducted involving 42 transplant recipients who developed new-onset or recurrent TB following solid organ transplantation (SOT) or hematopoietic stem cell transplantation (HSCT) between January 1, 2017, and February 28, 2025. The objective of this study was to investigate the clinical characteristics and prognosis of TB, as well as risk factors associated with severe TB among SOT and HSCT recipients.</div></div><div><h3>Results</h3><div>Among the 42 transplant recipients included in this study, the median time from SOT or HSCT to the onset of new or recurrent TB was 24 months (interquartile range [IQR]: 0.5–180 months). The median time from the symptom onset to TB diagnosis was 26 days (IQR: 1–180 days). The clinical types of TB comprised secondary pulmonary TB (36 cases, 85.71 %), disseminated TB (14 cases, 33.33 %), hematogenous disseminated pulmonary TB (7 cases, 16.67 %), and extrapulmonary TB (19 cases, 45.24 %). Co-infections were detected in 17 TB patients (40.48 %). Severe TB accounted for 28.58 % of all cases. Hypoproteinemia (OR = 0.532, 95 % CI 0.302–0.937; <em>P</em> = 0.029), co-infections (OR = 44.00, 95 % CI 4.712–410.855; <em>P</em> = 0.001), and early post-transplant onset of TB (OR = 0.963, 95 % CI 0.930–0.988; <em>P</em> = 0.036) were identified as independent risk factors for severe TB. The overall treatment success rate for TB was 57.14 %. The 6-month and 12-month overall survival rates were 85.7 % and 78.6 %, respectively.</div></div><div><h3>Conclusion</h3><div>Our findings indicate that TB may occur at any time following SOT or HSCT, and often affects extrapulmonary sites. Severe TB is relatively common and frequently associated with co-infections, which contribute to increased mortality. Clinically, these results underscore the importance of regular TB screening of transplant recipients.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102322"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of key predictors of acute GVHD in pediatric acute Leukemia using machine learning methods","authors":"İlknur Buçan Kırkbir ,&nbsp;Hacer Kobya Bulut","doi":"10.1016/j.trim.2025.102318","DOIUrl":"10.1016/j.trim.2025.102318","url":null,"abstract":"<div><h3>Backround</h3><div>Hematopoietic stem cell transplantation (HSCT) is a crucial treatment for leukemia. Allogeneic Hematopoietic cell transplantation (HCT), in which stem cells from a healthy donor are used, carries significant risks, including graft versus host disease (GVHD), a severe complication that leads to high morbidity and mortality. This study aimed to identify significant predictors of acute GVHD (aGVHD) in pediatric patients with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML).</div></div><div><h3>Methods</h3><div>This retrospective study analyzed the predictors of aGVHD in pediatric patients using different machine learning methods: Random Forest (RF), Logistic Regression (LR), and Boruta. The dataset was obtained from the UCI machine learning open-source database, and after balancing the class distribution of the dependent variable aGVHD using the Synthetic Minority Oversampling Technique (SMOTE), a total of 124 pediatric patients, including demographic and clinical variables, were analyzed using the R open-source programming language.</div></div><div><h3>Results</h3><div>Significant differences were observed between the aGVHD and non-aGVHD groups in recipient age (<em>p</em> = 0.002), recipient weight (<em>p</em> = 0.02), donor age (<em>p</em> = 0.01), allele mismatch (<em>p</em> = 0.01), antigen mismatch (<em>p</em> = 0.01), and recipient CMV status (<em>p</em> = 0.04). Feature importance analyses using Random Forest (RF) and Boruta identified recipient age, weight, and donor age as the most influential predictors of aGVHD. Logistic Regression (LR) highlighted recipient Rh-positive status and donor blood group B as additional relevant factors, offering a complementary perspective. These findings may assist in risk assessment and the development of preventive strategies for aGVHD.</div></div><div><h3>Conclusion</h3><div>Machine learning methods effectively identified important predictors of aGVHD, demonstrating their potential to improve post-HCT care and preventive protocols. Our results underscore the complex aGVHD etiology, suggesting the involvement of various factors in its development. Further studies should focus on integrating these findings into the clinical practice to enhance patient outcomes.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102318"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunomodulation in post-transplant diabetes mellitus: Challenges and management","authors":"Hanan Maoz,&nbsp;Amir Elalouf","doi":"10.1016/j.trim.2025.102304","DOIUrl":"10.1016/j.trim.2025.102304","url":null,"abstract":"<div><div>Solid organ transplantation (SOT) in diabetic patients presents unique challenges in balancing immunosuppression, glycemic control, and the risk of infection. Post-transplant diabetes mellitus (PTDM) affects 10 %–40 % of transplant recipients, with immunosuppressive therapies such as corticosteroids and calcineurin inhibitors (CNIs) contributing to insulin resistance and impaired beta-cell function. This review critically examines immunomodulation strategies in diabetic SOT recipients, focusing on optimizing immunosuppressive therapy while mitigating hyperglycemia-related complications. Early glycemic control through insulin therapy, followed by a transition to oral hypoglycemic agents such as metformin, GLP-1 receptor agonists, and DPP-4 inhibitors, has proven effective in reducing PTDM and enhancing long-term transplant outcomes. Alternative immunosuppressive strategies, including belatacept-based regimens and switching from tacrolimus to cyclosporine, offer promising methods to lower PTDM incidence while preserving graft survival. Personalized immunosuppressive regimens tailored to an individual's metabolic risks further improve patient outcomes. Emerging strategies, such as monoclonal antibodies, mesenchymal stem cell therapy, and localized immunomodulation, hold promise for enhancing immune balance while mitigating metabolic complications. A multidisciplinary team involving endocrinologists, transplant surgeons, and diabetes specialists is essential for comprehensive management. Additionally, routine screening for new-onset diabetes after transplantation (NODAT) and early interventions are vital to prevent long-term complications. Despite advancements, gaps remain regarding the long-term metabolic effects of immunosuppressive agents, the optimal timing for transitioning from insulin to oral therapy, and the role of new immunomodulatory treatments. Future research should focus on personalized therapeutic approaches that combine immunosuppressive and metabolic management to improve graft function and patient health. This review highlights the importance of a balanced approach to immunosuppression for diabetic transplant recipients, aiming to enhance survival rates and quality of life.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"93 ","pages":"Article 102304"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WITHDRAWN: Pretreatment hemoglobin, myeloma subtype, and induction regimens as independent prognostic factors for survival after autologous stem cell transplantation in multiple myeloma: A retrospective cohort study","authors":"Yong Zhang, Guangzhong Yang, Wen Gao, Wenming Chen","doi":"10.1016/j.trim.2025.102305","DOIUrl":"10.1016/j.trim.2025.102305","url":null,"abstract":"<p><p>This article has been withdrawn at the request of the author(s) and/or editor due to an error in the publishing process. The Publisher apologizes for any inconvenience this may cause.\u0000The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies-and-standards/article-withdrawal</p>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":" ","pages":"102305"},"PeriodicalIF":1.4,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for acute rejection in pediatric kidney transplantation","authors":"Roman Gorchs ,&nbsp;Matt Stout ,&nbsp;Brooke Cohen ,&nbsp;Jaden Ju ,&nbsp;Eileen Brewer ,&nbsp;Nhu Thao Nguyen Galván ,&nbsp;Abbas Rana","doi":"10.1016/j.trim.2025.102273","DOIUrl":"10.1016/j.trim.2025.102273","url":null,"abstract":"<div><h3>Background</h3><div>Acute rejection in pediatric kidney transplant patients can increase posttransplant costs and lead to limited survival of the graft. Identifying key risk factors for acute rejection in pediatric kidney recipients may allow for physicians to better tailor immunosuppressant regimens and decrease the occurrence of acute rejection.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed using kidney transplantation data provided by the United Network for Organ Sharing (UNOS) for patients younger than 18 years old who received their first kidney transplant between January 2005 and December 2022. The resulting study population consisted of 10,126 patients over the 18-year span. Risk factors for acute rejection in the first year post-transplant were identified using a multivariate analysis.</div></div><div><h3>Results</h3><div>Several variables were found to be statistically significant risk factors for acute rejection, including donor age ≤ 10 (Odds Ratio 1.44), Obese BMI (BMI-for-age z-score &gt; 2.0), (Odds Ratio 1.22), a 6 Human Leukocyte Antigen (HLA) mismatch (Odds Ratio 1.22) and recipient age between 15 and 18 (Odds Ratio 1.21). Multiple factors were found to be protective, including male sex (Odds Ratio 0.85) and recipient age between 5 and 10 (Odds Ratio 0.79).</div></div><div><h3>Conclusions</h3><div>The results indicate several significant risk factors such as the recipient age, Body Mass Index, sex and the number of HLA mismatches between the donor and the recipient. Physicians should consider these factors when personalizing immunosuppressive regimens for pediatric kidney transplant patients.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"92 ","pages":"Article 102273"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-transplant sensitization and its effect on heart transplant rejection and survival outcomes","authors":"Kyung-Hwa Shin ,&nbsp;Soo Yong Lee ,&nbsp;Min Ho Ju ,&nbsp;Hyun-Ji Lee","doi":"10.1016/j.trim.2025.102264","DOIUrl":"10.1016/j.trim.2025.102264","url":null,"abstract":"<div><h3>Background</h3><div>Sensitization of heart transplant (HT) recipients increases the risk of rejection. Assessment of sensitization using a calculated panel reactive antibody (cPRA) is crucial for evaluating transplant compatibility and predicting outcomes. This study investigated the impact of cPRA and pre-existing and <em>de novo</em> Human Leukocyte Antigen (HLA)-donor-specific antibodies (DSAs) on HT outcomes and aimed to identify recipients at a high risk of rejection.</div></div><div><h3>Methods</h3><div>This retrospective study included 121 adult recipients of HT from a single institution (2014–2023). cPRA values, flow cytometric crossmatches (FCXM), and DSAs were analyzed for their associations with antibody-mediated rejection (AMR) and T cell-mediated rejection (TCMR).</div></div><div><h3>Results</h3><div>Among the 121 HT recipients, 51.2 % experienced TCMR and 7.4 % experienced AMR. cPRA (I) ≥ 50 % was significantly associated with AMR, pre-existing DSA (pDSA), and positive FCXM. pDSA was present in 16.5 % of HT recipients and correlated with AMR but not mortality. <em>De novo</em> DSAs frequently emerged in 38 % of the recipients following TCMR episodes. Higher cPRA (I) levels correlated with increased rejection risk and shorter AMR-free survival.</div></div><div><h3>Conclusions</h3><div>High cPRA (≥50 %) significantly predicted the risk of AMR and correlated with pDSA and positive FCXM results. Pre-transplant cPRA assessment is crucial for identifying high-risk recipients and optimizing management strategies to improve HT outcomes.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"92 ","pages":"Article 102264"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The KIR/HLA class I co-expression and transplantation outcomes after HSCT/BMT from HLA-matched sibling donors","authors":"Joanna Dębska-Zielkowska ,&nbsp;Bartosz Słomiński ,&nbsp;Hanna Zielińska ,&nbsp;Anna Dukat-Mazurek ,&nbsp;Grażyna Moszkowska ,&nbsp;Maria Bieniaszewska ,&nbsp;Jan Maciej Zaucha ,&nbsp;Piotr Trzonkowski ,&nbsp;Maciej Zieliński","doi":"10.1016/j.trim.2025.102274","DOIUrl":"10.1016/j.trim.2025.102274","url":null,"abstract":"<div><h3>Background</h3><div>Natural killer (NK) cells express killer immunoglobulin-like receptors (KIRs), which regulate their functions. Self-human leukocyte antigens (HLA) class I molecules act as inhibitory molecules for KIRs, blocking the killing activity of NK cells. Since normal NK activity may affect the outcomes of hematopoietic stem cell transplantation (HSCT) or bone marrow transplantation (BMT) from their HLA-matched sibling donors, we investigated the interaction between KIRs and class I HLA presented on NK cells. Complications such as graft-versus-host disease (GvHD) or transplant rejection may result because of deficient expression of class I HLA ligand inhibitors in the transplant recipient.</div></div><div><h3>Methods</h3><div>We examined the effect of missing KIR ligands (MSL) and KIR haplotypes on GvHD development, relapses, death, infections, and cell recovery in HSCT patients. Our group included 59 patients [<em>n</em> = 24 with acute myeloid leukemia (AML), <em>n</em> = 12 with chronic myeloid leukemia (CML), n = 12 with myelodysplastic syndrome (MDS), and <em>n</em> = 11 with acute lymphoblastic leukemia (ALL)], who received HSCT/BMT from their sibling donors.</div></div><div><h3>Results</h3><div>Our results showed that haplotype AA was more common than Bx in donors for patients with MDS and was associated with a higher incidence of chronic (c) GvHD (<em>p</em> = 0.003). In this group, we also observed a statistically significant relationship between the AA donor haplotype and absolute neutrophil count reconstruction of 0.5 G/l (0.5 × 10⁹ cells/L) under 28 days (<em>p</em> = 0.03). Our results also showed an excellent correlation between KIR MSL values and cGvHD in AML patients (<em>r</em> = 0.9932).</div></div><div><h3>Conclusion</h3><div>Our results indicate that KIR/HLA class I analysis at the stage of selection of a related donor could have an impact on the results of hematological transplantation and possibly reduce complications.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"92 ","pages":"Article 102274"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}