HLA antibodies in kidney transplantation

In renal transplantation donor-recipient HLA-matching is performed considering HLA-A, B and DR "broad" antigens. Several studies had demonstrated that sensitized patients could produce antibodies against all HLA class I and Il molecules. In 350 HLA class I and/or class Il antibody positive patients awaiting renal transplantation, we characterized detected antibodies using FlowPRA/LABScreen Single Antigens beads. We also investigated production of antibodies specific for an other split or an other allele of the patient own HLA molecule, that is "intra-broad antigen" (IBA) or "intra-allele" (IA) antibodies. The epitope specifictity of IBA-/IA-antibodies was analyzed comparing amino acid sequences of patient's HLA molecules to those of HLA allele/s corresponding to IBA-/IA-antibodies using online database. Our data strongly confirm the epitope specificity of HLA alloantibodies and underline the importance to utilize a "structural" HLA matching in kidney transplantation of sensitized patients.