Influence of HLA-A, B, and -DRB1 genes and panel-reactive antibodies on the waitlist time for kidney transplantation in the state of Sao Paulo-Brazil

Transpl Immunol. 2024 Apr:83:101981. doi: 10.1016/j.trim.2023.101981. Epub 2024 Jan 4.

Abstract

Background: Brazil ranks second in the absolute number of transplants. However, the supply remains insufficient to meet the demands, resulting in a lengthy waitlist. This study aimed to analyze whether the frequency of human leukocyte antigen (HLA) and the value of calculated panel reactive antibody (cPRA) would influence the waiting time for kidney transplantation.

Methods: The HLA-A, B, and -DRB1 frequencies and the cPRA value were analyzed in 11,186 kidney transplant candidates included in the waitlist from 2006 to 2016.

Results: The most frequent alleles were HLA-A*02, HLA-B*35, and HLA-DRB1*13. The overall mean length of stay on the list was 986 ± 1001 days. The mean waiting time for the three most frequent alleles of the HLA-A and B loci showed no significant difference when compared with the least frequent alleles; however, for the HLA-DRB1 locus, the most frequent alleles showed a shorter waiting time. In the association between HLA and PRA, the average length of stay on the list increased according to the candidate's degree of sensitization, regardless of the analyzed HLA frequency.

Conclusion: The length of stay on the waitlist is influenced by the frequency of the HLA alleles of the DRB1 locus and the degree of sensitization.

Keywords: HLA alleles; Kidney transplantation; Panel reactive antibodies; Waiting list time.

MeSH terms

  • Alleles
  • Antibodies
  • Brazil
  • Gene Frequency
  • HLA Antigens
  • HLA-A Antigens / genetics
  • HLA-DRB1 Chains / genetics
  • Humans
  • Kidney Transplantation*
  • Waiting Lists

Substances

  • HLA-DRB1 Chains
  • HLA-A Antigens
  • HLA Antigens
  • Antibodies