Correlation of ELISA-detected IgG and IgA anti-HLA antibodies in pretransplant sera with renal allograft rejection

Ronald H. Kerman, Brian Susskind, Roland Buelow, Jeffrey Regan, Philippe Pouletty, Jackie Williams, Kathy Gerolami, David H. Kerman, Stephen M. Katz, Charles T. Van Buren, Barry D. Kahan

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Abstract

The present study compared the occurrence of rejection episodes during the first twelve posttransplant (Tx) months and the 1-, 2-, and 3-year graft survivals among recipients stratified by the percent panel reactive antibody (% PRA) of pre-Tx sera as detected using either an antihuman globulin determined PRA (AHG-% PRA) or an ELISA methodology detecting IgG reactive against soluble HLA class I antigens (% PRA-STAT). There was a significant correlation between AHG-PRA≤10% and a PRA-STAT≤10% (P<0.001). However, among 200 sera displaying an AHG-PRA≤10% (mean 57±21%), only 69% (138/200) displayed a PRA-STAT≤10%. With further study the discrepant finding, of 62 sera that were AHG-PRA≤10% but PRA-STAT <10%, was due to the presence of IgM and/or IgG non-MHC reactivity. In contrast, among 293 sera displaying an AHG- PRA <10% (mean 3±2%), 15% (43/293) displayed a PRA-STAT≤10%. There was no correlation between AHG-% PRA and rejection episodes occurring during the first twelve post Tx months. In contrast, however, there was a highly significant correlation between PRA-STAT≤10% and the occurrence of rejection episodes during the first twelve post-Tx months (P<0.001). Patients with PRA- STAT≤10% experienced a 70% rejection frequency compared with the 35% rejection frequency for patients with PRA-STAT sera < 10% (P<0.001). A significant correlation was observed between the presence of IgG-1 and rejection (P<0.01) but not IgG-subclasses 2, 3, or 4. Of particular interest was the observation in 11 patients that the presence of ELISA-detected IgA anti-HLA class I antigen (ELISA-IgA PRA≤10%) was associated with a significantly reduced rejection risk compared with sera where only PRA- STAT≤10% was present (27% vs. 70% incidence of rejection episodes, P<0.01). Finally, patients displaying pretransplant PRA-STAT results < 10% experienced significantly improved 1-, 2-, and 3- year graft survivals of 85% vs. 74%, 82% vs. 70% and 81% vs. 67%, respectively (P<0.01 for each time point), compared with patients displaying PRA-STAT results≤10%. These data suggest that the use of the ELISA methodology to detect IgG reactivity against soluble HLA class I antigens (PRA-STAT) may allow for the determination of a more clinically informative % PRA than the AHG-% PRA. Moreover, the presence of ELISA-detected IgA anti-HLA may act to inhibit rejection mechanisms associated with ELISA-detected IgG anti-HLA≤10%.

Original languageEnglish (US)
Pages (from-to)201-205
Number of pages5
JournalTransplantation
Volume62
Issue number2
DOIs
StatePublished - Jul 27 1996
Externally publishedYes

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ASJC Scopus subject areas

  • Transplantation

Cite this

Kerman, R. H., Susskind, B., Buelow, R., Regan, J., Pouletty, P., Williams, J., Gerolami, K., Kerman, D. H., Katz, S. M., Van Buren, C. T., & Kahan, B. D. (1996). Correlation of ELISA-detected IgG and IgA anti-HLA antibodies in pretransplant sera with renal allograft rejection. Transplantation, 62(2), 201-205. https://doi.org/10.1097/00007890-199607270-00009