HLA – A, HLA – B, HLA – DR allele frequencies between kidney recipients with different blood group

Abstract

Introduction: Human leukocyte antigens (HLA) play a central role in the cellular and humoral immune responses that determine the outcome of a transplant. The extensive polymorphism of HLA poses a major barrier to successful transplantation. Blood groups refer not only to genetically encoded erythrocyte antigens but also the immunologic diversity expressed by other blood constituents, including leukocytes, platelets, and plasma. The ABO blood group system has the single most important blood group antigens. Kidney donors must have a compatible blood type with the recipient for the transplant to be accepted by the recipient’s organism and immune system.

Aim:To evaluate kidney recipients’ HLA allele frequencies among patients with different blood groups.

Objective: 1. To determine the most frequent HLA – A, HLA – B, HLA – DR alleles among kidney recipients. 2. To compare HLA – A allele frequencies among kidney recipients with different blood groups. 3. To compare HLA – B allele frequencies among kidney recipients with different blood groups. 4. To compare HLA – DR allele frequencies among kidney recipients with different blood groups.

Methods: The retrospective data analysis of patients who were in the waitlist for kidney transplant in Hospital Lithuanian University of Health Sciences Kaunas Clinics during years 2013 – 2014 was performed. The following data was analyzed: ABO blood group antigens detected using column agglutination technique and class I (HLA – A, HLA – B), class II (HLA – DR) HLA antigens, detected using either lymphocytotoxic or molecular biology method. Data analysis was performed using Microsoft Excel and SPSS 19.0 software package. To assess the significance of the results the method of chi-square (X2) was used, assuming the results to be statistically significant with p<0,05.

Results: The study included 250 LUHS Kaunas clinics patients waiting for kidney transplant. The most frequent (rate >8%) HLA-A, HLA-B, HLA-DR alleles were determined. The most frequent of the HLA-A alleles were 1 (8.8%), 2 (30.8%), 3 (16%), 11 (8%). Among HLA-B, the most frequent were 7 (28%), 8 (10.8%), 13 (10%). And among HLA-DR alleles: 1 (15%), 4 (12%), 7 (13.2%), 8 (8%) and 15 (8.8%). HLA-A 11 allele presence among different blood groups was statistically significant (p = 0.008); 36 out of 250 patients had this allele, it was detected in different blood groups in the following frequencies: O (n = 11; 32.4%), A (n = 8; 23.5%), B (n = 10; 29.4%), AB (n = 5, 14.7%). HLA-B 7 allele presence among different blood groups was statistically significant (p = 0.042), 65 out of 250 patients had this allele, it was detected in different blood groups in the following frequencies: O (n = 26; 43.3%), A (n = 22; 36.7%), B (n = 9; 15.0%), AB (n = 3; 5%). HLA-DR 8 allele presence among different blood groups was statistically significant (p = 0.028); 33 out of 250 patients had this allele, it was detected in different blood groups in the following frequencies: O (n = 11; 34.4%), A (n = 10; 31.3% ), B (n = 5, 15.6%), AB (n = 6; 18.78%).The presence of other HLA-A (1, 2, 3), HLA-B (8; 13) and HLADR (1; 4; 7; 15) alleles in blood groups was not statistically significant, p> 0.05.

Conclusions: 1. 1. The most frequently observed alleles were the following: HLA–A: 1, 2, 3, 11: HLA–B: 7, 8, 13; HLA–DR: 1, 4, 7, 8, 15. 2. HLA–A 11 allele dominated between kidney recipients with O and B blood groups. 3. HLA–B 7 allele dominated between kidney recipients with O and A blood groups. 4. HLA–DR 8 allele dominated between kidney recipients with O and A blood groups.

Keywords: HLA-A, HLA-B, HLA-DR.