Prevalence of anti-HLA antibodies in highly sensitized kidney transplant candidates

Introduction: Kidney transplantation is the standard gold therapy for the treatment of the majority of end-stage renal diseases (ESRDs). Despite the general success rate of allogeneic transplantation due to immunosuppressive therapy, it is difficult to find an appropriate donor for some sensitized patients. Objectives: This study aimed to estimate the prevalence and titers of anti-HLA-class I and anti-HLA-class II antibodies in sensitized patients in a kidney transplantation center. The history of the risk factors of sensitization was studied. Patients and Methods: Twenty highly sensitized ESRD patients with a calculated panel-reactive antibody (CPRA) ≥50% were selected, and anti-HLA-I and anti-HLA-II antibodies were assessed in their sera using a single antigen bead (SAB) Luminex assay. Results: The previous history of kidney transplantation was the most critical sensitization risk factor. The results indicated that HLA A*24:02 and DQA1*02:01/DQB1*06:02 were the most frequent antibodies in class I and class II, respectively. Moreover, the mean fluorescence intensity (MFI) levels of anti-HLA class II antibodies were significantly higher than the MFI levels of anti-HLA class I antibodies. Conclusion: According to the findings of this study, matching HLA alleles, particularly class II molecules, can reduce sensitization in the first kidney transplant. A better understanding of the sensitization status of transplant candidates could be gained by examining CPRA values.