[Immunological monitoring in kidney transplantation: 13 years experience of a Moroccan histocompatibility laboratory]

Transfus Clin Biol. 2016 May;23(2):86-94. doi: 10.1016/j.tracli.2015.12.009. Epub 2016 Jan 12.
[Article in French]

Abstract

Purpose of study: The quality of the immunological monitoring is crucial because it determines the success of the kidney transplantation. The scope of this work is to describe the experience of the department of immunological unity of the Ibn Sina university hospital in Rabat regarding the immunological monitoring of patients transplanted between 2001 and 2014.

Patients and methods: Patient samples were collected from nephrology services of different public and private hospitals of Morocco. The tests conducted in the context of immunological monitoring are ABO typing, HLA-A, B, DR, DQ typing, anti-HLA antibodies detection and identification and cross-match.

Results: One hundred and fourteen benefited from a pre- and post-transplant immunological monitoring in our laboratory. The percentage of recipients having between 2 and 5 stored sera is 60.5 before transplantation and 56.1 after transplantation. Immunized patients account for 22.8% before the transplant and 17.6% after transplantation. Ninety-seven patients still have a functional graft, while 4 of them had DSA of low intensity before transplantation. Five immunological rejections were reported while the cross-match were negative and no DSA was identified before transplantation. Patient survival and graft at 1 year was 98.2% and 92.7% respectively.

Conclusion: Conducting regular immunological monitoring is sometimes difficult in our context, however, the results are satisfactory in terms of graft and patients survival.

Keywords: DSA; Immunological monitoring; Kidney transplantation; Luminex; Maroc; Morocco; Rejection; Rejet; Suivi immunologique; Transplantation rénale.

MeSH terms

  • ABO Blood-Group System / analysis
  • Adolescent
  • Adult
  • Aged
  • Blood Grouping and Crossmatching / methods
  • Blood Grouping and Crossmatching / statistics & numerical data
  • Child
  • Child, Preschool
  • Female
  • HLA Antigens / analysis
  • Histocompatibility
  • Histocompatibility Testing* / methods
  • Histocompatibility Testing* / statistics & numerical data
  • Hospital Departments
  • Hospitals, Private / statistics & numerical data
  • Hospitals, Public / statistics & numerical data
  • Humans
  • Isoantibodies / blood
  • Kidney Transplantation* / statistics & numerical data
  • Male
  • Middle Aged
  • Morocco
  • Nephrology
  • Retrospective Studies
  • Transplantation Immunology
  • Young Adult

Substances

  • ABO Blood-Group System
  • HLA Antigens
  • Isoantibodies