Evidencia del impacto de los anticuerpos anti-HLA y anti-MICA en la pérdida del injerto renal

SUMMARY Background: HLA and MICA antibodies are increasingly associated with poorer graft survival. The aim of this study is to report the frequency of graft loss 2 years after the detection of HLA abs and MICA abs among a group of kidney transplant recipients. Methods: We tested 196 patients with a functioning graft. Sera were screened for HLA and MICA IgG abs by Luminex, using the LABScreen Mixed, and LABScreen PRA. The sera were screened for MICA abs by Luminex. Results: Of 196 kidney transplant recipients (mean age 36.7 years, 42% female), one hundred twenty four (63.3%) were negative to all tested abs, and 72 (36.7%) were positive for: HLA abs alone=34, MICA abs alone=29, and HLA+MICA abs=9. At a median followup of 20.5 (1.2-25.2) months, 8 patients lost their grafts due to biopsy-confirmed chronic allograft injury: 2/124 (1.6%) abnegative, and 6/72 (8.3%) ab-positive, with a significantly lower survival for the Ab-positive group (p=0.046, log-rank test). Conclusions: The presence of circulating abs was associated with an increased risk of graft loss, and the coexistence of HLA and MICA absincreases the risk of graft loss.