DOI: https://doi.org/10.22263/2312-4156.2017.3.54
Zybleva S.V.1, Zyblev S.L.2, Svistunova Е.A.1, Kabeshev B.O.1, Zlotnikova M.V.3
Clinical and genetic peculiarities of renal allograft recipients
1The Republican Research Center for Radiation Medicine and Human Ecology, Gomel, Republic of Belarus
2Gomel State Medical University, Gomel, Republic of Belarus
3RSPC of Transfusiology and Medical Biotechnologies, Minsk, Republic of Belarus
Vestnik VGMU. 2017;16(3):54-62.
Abstract.
Objective. To study peculiarities of histocompatibility on HLA I class at renal allotransplantation.
Material and methods. There were studied 119 case histories of patients with terminal renal insufficiency (tCKD) who underwent kidney transplantation. Antigens of HLA system of locuses A and B were assessed in microlymphocytotoxic test. Incidence of antigens was detected as percentage of individuals carrying antigen to total number of examined patients in the group. Compatibility was assessed at the level of serological specificities; the antigen was considered to be incompatible if it was presented in the phenotype of donor but was absent in the phenotype of recipient.
Results. There were not detected any significant differences (p>0,05 for all specificities of HLA-A at incidence comparison of antigens HLA-A and HLA-B in the groups of recipients and donors of renal allograft. Mismatch of two antigens (one in each locus A and B) prevails in the percentage of the number of mismatches of antigens HLA I class. Also the incidence of mismatch only on HLA-A and only on HLA-B antigens was practically the same (22,22% и 19,05% respectively).
Conclusions. In spite of absence of genetic heterogeneity in the incidence of HLA class I antigens within the groups (p>0,05) for all the specificities of HLA-A and HLA-B, in 41,27% of cases the recipients of the kidney allograft had incompatibility with at least two HLA antigens (one mismatch in locus A and locus B). Thus, it is required to expand the list of tests for laboratory support and selection of a donor-recipient pair taking into account the results of HLA-typing in class II (locus HLA-DRB1). This will increase the probability of coincidence in the HLA system and will prove to be an effective preventive measure in the development of allograft rejection.
Key words: renal transplantation, HLA system, histocompatibility.
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Information about authors:
Zybleva S.V. – Candidate of Medical Sciences, academic secretary, immunologist, Republican Research Center for Radiation Medicine and Human Ecology;
Zyblev S.L. – Candidate of Medical Sciences, associate professor of the Chair of Surgical Diseases No. 2, Gomel State Medical University;
Svistunova E.A. – nephrologist, Republican Research Center for Radiation Medicine and Human Ecology;
Kabeshev B.O. – Candidate of Medical Sciences, surgeon of the surgical department (transplantation, reconstructive and endocrine surgery), Republican Research Center for Radiation Medicine and Human Ecology;
Zlotnikova M.V. – Candidate of Medical Sciences, physician of laboratory diagnosis, head of the laboratory of immunologic typing of organs and tissues, RSPC of Transfusiology and Medical Biotechnologies.
Correspondence address: Republic of Belarus, 246000, Gomel, 5 Ilicha str., Republican Research Center for Radiation Medicine and Human Ecology, Scientific Department. E-mail: zyb-svetlana@ yandex.by – Svetlana V. Zybleva.
