INVITRO STUDIES TO EXPLAIN HIGH RENAL-ALLOGRAFT SURVIVAL IN IGA NEPHROPATHY PATIENTS

The pretransplant sera of 27 IgA nephropathy (N) kidney transplant pat ients were investigated for antibodies to the HLA molecule, together w ith 104 sera from non-IgA N patients and 60 controls. IgA antibodies t o HLA were found in 61% of IgA N patients and 2% of non-IgA N patients . IgA N patients with IgA antibodies to HLA had a 100% 2-year cadaver donor graft survival rate compared with 70% in those without IgA antib odies. Patients with IgG antibodies to HLA without accompanying IgA an tibodies had the worst graft survival rates. We propose that IgA anti- HLA contributes to the high kidney graft survival in IgA N patients by blocking IgG antibodies or inhibiting cellular immune response.