2e5fc00007129d50a3f8dd79993be712 pmc_33947168.pdf 5918b7a5de03e926bb47592d7e7efe74a633b3ad pmc_33947168.pdf 36fc817e8218290852f1a4e4caa9e0fa3d1a8e170449fd2de10a00936222d88b pmc_33947168.pdf Title: Impact of HLA Mismatching on Early Subclinical Inflammation in Low-Immunological-Risk Kidney Transplant Recipients Subject: The impact of human leukocyte antigen (HLA)-mismatching on the early appearance of subclinical inflammation (SCI) in low-immunological-risk kidney transplant (KT) recipients is undetermined. We aimed to assess whether HLA-mismatching (A-B-C-DR-DQ) is a risk factor for early SCI. As part of a clinical trial (Clinicaltrials.gov, number NCT02284464), a total of 105 low-immunological-risk KT patients underwent a protocol biopsy on the third month post-KT. As a result, 54 presented SCI, showing a greater number of total HLA-mismatches (p = 0.008) and worse allograft function compared with the no inflammation group (48.5 13.6 vs. 60 23.4 mL/min; p = 0.003). Multiple logistic regression showed that the only risk factor associated with SCI was the total HLA-mismatch score (OR 1.32, 95%CI 1.06–1.64, p = 0.013) or class II HLA mismatching (OR 1.51; 95%CI 1.04–2.19, p = 0.032) after adjusting for confounder variables (recipient age, delayed graft function, transfusion prior KT, and tacrolimus levels). The ROC curve illustrated that the HLA mismatching of six antigens was the optimal value in terms of sensitivity and specificity for predicting the SCI. Finally, a significantly higher proportion of SCI was seen in patients with >6 vs. 6 HLA-mismatches (62.3 vs. 37.7%; p = 0.008). HLA compatibility is an independent risk factor associated with early SCI. Thus, transplant physicians should perhaps be more aware of HLA mismatching to reduce these early harmful lesions. Keywords: kidney transplantation; HLA compatibility; subclinical inflammation; Banff criteria; low-immunological risk Author: Domingo Hernández, Teresa Vázquez, Juana Alonso-Titos, Myriam León, Abelardo Caballero, María Angeles Cobo, Eugenia Sola, Verónica López, Pedro Ruiz-Esteban, Josep María Cruzado, Joana Sellarés, Francesc Moreso, Anna Manonelles, Alberto Torio, Mercedes Cabello, Juan Delgado-Burgos, Cristina Casas, Elena Gutiérrez, Cristina Jironda, Julia Kanter, Daniel Serón and Armando Torres Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri May 7 16:09:41 2021 CEST ModDate: Fri May 7 16:16:56 2021 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 10 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 722379 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- OPZDHV+VnURWPalladioL Type 1 Custom yes yes no 10 0 YKVCEJ+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 WEVQQT+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 MCLNGJ+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 JLGPER+CMSY10 Type 1 Builtin yes yes no 28 0 JYPLJJ+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 40 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 43 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 65 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 69 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 73 0 GGIFTX+URWPalladioL-BoldItal Type 1 Custom yes yes no 91 0 HLMNCE+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 109 0 HLMNCG+PalatinoLinotype TrueType WinAnsi yes yes no 112 0 HLMNCI+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 115 0 HLMNCE+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 134 0 HLMNCF+PalatinoLinotype CID TrueType Identity-H yes yes yes 137 0 HLMNCG+PalatinoLinotype TrueType WinAnsi yes yes no 143 0 HLMNCI+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 146 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2021-09-11 03:21:35 CEST RepresentationInformation: pmc_33947168.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2021-05-24 03:37:22 CEST Size: 722379 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 297 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Material and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Info: Title: Impact of HLA Mismatching on Early Subclinical Inflammation in Low-Immunological-Risk Kidney Transplant Recipients Author: Domingo Hernández, Teresa Vázquez, Juana Alonso-Titos, Myriam León, Abelardo Caballero, María Angeles Cobo, Eugenia Sola, Verónica López, Pedro Ruiz-Esteban, Josep María Cruzado, Joana Sellarés, Francesc Moreso, Anna Manonelles, Alberto Torio, Mercedes Cabello, Juan Delgado-Burgos, Cristina Casas, Elena Gutiérrez, Cristina Jironda, Julia Kanter, Daniel Serón and Armando Torres Subject: The impact of human leukocyte antigen (HLA)-mismatching on the early appearance of subclinical inflammation (SCI) in low-immunological-risk kidney transplant (KT) recipients is undetermined. We aimed to assess whether HLA-mismatching (A-B-C-DR-DQ) is a risk factor for early SCI. As part of a clinical trial (Clinicaltrials.gov, number NCT02284464), a total of 105 low-immunological-risk KT patients underwent a protocol biopsy on the third month post-KT. As a result, 54 presented SCI, showing a greater number of total HLA-mismatches (p = 0.008) and worse allograft function compared with the no inflammation group (48.5 13.6 vs. 60 23.4 mL/min; p = 0.003). Multiple logistic regression showed that the only risk factor associated with SCI was the total HLA-mismatch score (OR 1.32, 95%CI 1.06 1.64, p = 0.013) or class II HLA mismatching (OR 1.51; 95%CI 1.04 2.19, p = 0.032) after adjusting for confounder variables (recipient age, delayed graft function, transfusion prior KT, and tacrolimus levels). The ROC curve illustrated that the HLA mismatching of six antigens was the optimal value in terms of sensitivity and specificity for predicting the SCI. Finally, a significantly higher proportion of SCI was seen in patients with >6 vs. 6 HLA-mismatches (62.3 vs. 37.7%; p = 0.008). HLA compatibility is an independent risk factor associated with early SCI. Thus, transplant physicians should perhaps be more aware of HLA mismatching to reduce these early harmful lesions. 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