KLI

Prediction of HLA-DQ in Deceased Donors and its Clinical Significance in Kidney Transplantation

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Abstract
Background: HLA-DQ typing in deceased donors is not mandatory in Korea. Therefore, when patients develop DQ antibodies after kidney transplantation (KT) from deceased donor, it is impossible to determine whether they are donor-specific antibodies (DSA). We developed DQ prediction programs for the HLA gene and evaluated their clinical utility.

Methods: Two HLA-DQ prediction programs were developed: one based on Lewontin's linkage disequilibrium (LD) and haplotype frequency and the other on an artificial neural network (ANN). Low-resolution HLA-A, -B, -DR, and -DQ typing data of 5,603 Korean patients were analyzed in terms of haplotype frequency and used to develop an ANN DQ prediction program. Predicted DQ (pDQ) genotype accuracy was analyzed using the typed DQ data of 403 patients. pDQ DSA agreement, sensitivity, specificity, and false-negative rate was evaluated using 1,970 single-antigen bead assays performed on 885 KT recipients. The clinical significance of DQ and pDQ DSA was evaluated in 411 KT recipients.

Results: pDQ genotype accuracies were 75.4% (LD algorithm) and 75.7% (ANN). When the second most likely pDQ (LD algorithm) was also considered, the genotype accuracy increased to 92.6%. pDQ DSA (LD algorithm) agreement, sensitivity, specificity, and false-negative rate were 97.5%, 97.3%, 98.6%, and 2.4%, respectively. The antibody-mediated rejection treatment frequency was significantly higher in DQ or pDQ DSA-positive patients than in DQ or pDQ DSA-negative patients (P<0.001).

Conclusions: Our DQ prediction programs showed good accuracy and could aid DQ DSA detection in patients who had undergone deceased donor KT without donor HLA-DQ typing.
Author(s)
고선영김수경성흥섭신성양정석오흥범황상현
Issued Date
2021
Type
Article
Keyword
Artificial neural networkDonor-specific antibodyHLA-DQKidney transplantationLinkage disequilibriumOriginal병리학
DOI
10.3343/alm.2021.41.2.190
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8570
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_nrf_kci_oai_kci_go_kr_ARTI_9748561&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Prediction%20of%20HLA-DQ%20in%20Deceased%20Donors%20and%20its%20Clinical%20Significance%20in%20Kidney%20Transplantation&amp;offset=0&amp;pcAvailability=true
Publisher
ANNALS OF LABORATORY MEDICINE
Location
대한민국
Language
한국어
ISSN
2234-3806
Citation Volume
41
Citation Number
2
Citation Start Page
190
Citation End Page
197
Appears in Collections:
Medicine > Medicine
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