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Tang MS, Wang M, Chang SH, et al. Association of Bw4/Bw6 mismatch across class I HLA loci with renal graft outcomes in first time transplants. Hum Immunol. 2021;82(10):767-774doi: 10.1016/j.humimm.2021.07.008.
Tang, M. S., Wang, M., Chang, S. H., Alhamad, T., & Liu, C. (2021). Association of Bw4/Bw6 mismatch across class I HLA loci with renal graft outcomes in first time transplants. Human immunology, 82(10), 767-774. https://doi.org/10.1016/j.humimm.2021.07.008
Tang, Mei San, et al. "Association of Bw4/Bw6 mismatch across class I HLA loci with renal graft outcomes in first time transplants." Human immunology vol. 82,10 (2021): 767-774. doi: https://doi.org/10.1016/j.humimm.2021.07.008
Tang MS, Wang M, Chang SH, Alhamad T, Liu C. Association of Bw4/Bw6 mismatch across class I HLA loci with renal graft outcomes in first time transplants. Hum Immunol. 2021 Oct;82(10):767-774. doi: 10.1016/j.humimm.2021.07.008. Epub 2021 Aug 03. PMID: 34362574.
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Hum Immunol. 2021 Oct;82(10):767-774. doi: 10.1016/j.humimm.2021.07.008. Epub 2021 Aug 03.

Association of Bw4/Bw6 mismatch across class I HLA loci with renal graft outcomes in first time transplants.

Human immunology

Mei San Tang, Mei Wang, Su-Hsin Chang, Tarek Alhamad, Chang Liu

Affiliations

  1. Department of Pathology and Immunology, Washington University in St Louis, MO, United States.
  2. Division of Public Health Sciences, Department of Surgery, Washington University in St Louis, MO, United States.
  3. Division of Nephrology, Department of Internal Medicine, Washington University in St Louis, MO, United States.
  4. Department of Pathology and Immunology, Washington University in St Louis, MO, United States. Electronic address: [email protected].

PMID: 34362574 DOI: 10.1016/j.humimm.2021.07.008

Abstract

Bw4 and Bw6 are strongly immunogenic epitopes routinely assigned based on HLA-B typing results per Organ Procurement and Transplantation Network (OPTN) policies. These public epitopes and their variants are shared by some cross-reactive HLA-A and -C antigens. Although epitope mismatch has been associated with poor transplant outcomes, previous studies did not find such associations for Bw4/6 mismatch as defined by HLA-B antigens only. We hypothesized that a broader definition for Bw4/Bw6 mismatch that includes cross-reactive HLA-A and -C antigens may reveal the risk associated with these epitopes. In this retrospective cohort study, we examined kidney transplantations between 2000 and 2016 in the OPTN database and determined the association of Bw4/6 mismatch across all class I HLA antigens and renal graft outcomes. Even by this broader definition, Bw4/6 mismatch was not independently associated with 1-year graft rejection (adjusted OR: 0.99, 95%CI 0.93-1.06) or death-censored graft survival (adjusted HR: 1.02, 95%CI 1.00-1.05). There was no significant association among recipients who were already sensitized at transplant either. Our findings suggest that Bw4/6 mismatch alone is not associated with poor renal graft outcomes despite their strong immunogenicity, and the load of epitope mismatches over a certain threshold is likely required to cause adverse clinical consequences.

Copyright © 2021 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.

Keywords: Bw4; Bw6; Epitope mismatch; Kidney transplantation; OPTN

Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this pa

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