Impact of post transplant development of HLA antibodies and MICA antibodies on renal allograft function.

Objective To study the impact of post transplant development of human leucocyte antigen(HLA)antibodies and MHC class I chain-related A antigen(MICA)antibodies on renal allograft function.Methods Post transplant sera of 96 renal transplantation patients were tested by Luminex flow cytometry for HLA antibodies and MICA antibodies.According to the test results,patients were divided into the HLA antibodies-positive(HLA+)group,MICA antibodies-positive(MICA+)group,and HLA antibodies and MICA antibodies-negative(HLA-/MICA-)group.The incidence of adverse immune events was compared among these groups.According to having acute rejection(AR)or not,patients were divided into the AR+group and AR-group,and the impacts of HLA antibodies and MICA antibodies on renal graft function were observed.Results The AR incidence in the HLA+ group was higher than in the HLA-/MICA-groups(43.5% vs 11.7%,P0.05).There was no statistical significance in the AR episodes between the MICA+ group and the HLA-/MICA-groups(15.3% vs 11.7%,P0.05).Higher serum creatinine levels in the 1st,3rd,6th and 12th months after transplantation were evidenced in the HLA+ group with more AR episodes than in those who had AR but did not produce antibodies.In the MICA+ group with AR,the serum creatininelevels in the 1st and 3rd months after transplantation were higher than in patients with AR but without antibodies.Urine protein quantitation in the MICA+ group in the 6th and 12th months after transplantation exceeded 150 mg and increased with time.Conclusion HLA antibodies play an important role in AR episodes after kidney transplantation and the renal allograft function could be damaged by HLA antibodies.MICA antibodies may result in an increase in urine protein quantitation for the kidney recipient and may damage renal allograft function.