ArticleFrontiers in nephrology2026
Effect of preexisting human leukocyte antigen donor-specific antibodies especially human leukocyte antigen-DQ on kidney transplant outcome.
Article in Frontiers in nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Corrections and comments
- Erratum issued
Authors and funding
5 authors.
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Abstract
Background: Anti-HLA-DQ donor-specific antibodies are increasingly recognized for their role in early rejection and compromised graft function following kidney transplantation. Methods: A total of 119 prospective kidney transplant recipients were evaluated for pre-transplant HLA sensitization using single antigen bead (SAB) assays for class I and class II donor-specific antibodies (DSAs). All patients had negative complement-dependent cytotoxicity (CDC) crossmatch results; however, flow cytometry crossmatch was positive for T cells in three patients and showed borderline B-cell positivity in one patient. Of these patients, 100 proceeded to kidney transplantation, including 19 ABO-incompatible transplants. All recipients were followed for a minimum of 4 years post-transplant, and induction immunosuppression was administered using either anti-thymocyte globulin (ATG) or ATLG (Grafalon Results: A total of 100 patients underwent kidney transplant. Among them, 34 recipients (34%) had class I HLA antibodies (MFI range: 9,057 to 757) and 5 had class I DSAs (MFI range: 2,084 to 822) without any rejection episodes. Thirty-eight patients (38%) tested positive for class II HLA antibodies, including 20 with anti-HLA-DQ (MFI range: 7,725 to 766); of these, eight had donor-specific anti-DQ antibodies. Only one patient, who underwent an ABO-incompatible transplant and had pre-transplant DQ DSA with MFI 7,725, developed biopsy-proven antibody-mediated rejection (ABMR) but recovered following treatment. All eight DQ DSA-positive recipients showed post-transplant MFI decline within 1 month. Rejection was notably infrequent in recipients who received Grafalon Conclusions: Preformed anti-HLA-DQ DSAs, especially with MFI >5,000 and in the context of ABO incompatibility, may predispose to AMR. DQ DSAs with lower MFI require vigilant monitoring due to the risk of post-transplant rebound. ATLG-based induction was associated with low rejection incidence and favorable short-term outcomes.
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