THE ROLE OF IGA ANTI-HLA CLASS-I ANTIBODIES IN KIDNEY-TRANSPLANT SURVIVAL

The unusually high 88% one-year cadaver kidney graft survival rate in patients with IgA nephropathy (IgAN) prompted us to investigate the in fluence of IgA anti-HLA class I antibodies on subsequent graft surviva l. We found that patients with various original diseases with IgA anti bodies to the HLA molecule had high 91% one-year graft survival compar ed with 58% one-year survival for those who did not have preformed IgA antibodies against the HLA molecule prior to transplantation (P<0.000 5). The IgA antibodies were detected by reaction with class I HLA mole cules isolated by capture with monoclonal antibody and detected with a n enzyme-linked immunosorbent assay. In contrast, IgG antibodies to th e HLA molecule resulted in a lower one-year graft survival rate (74%) than in those patients without IgG antibodies (87%) (p=0.08). IgA anti bodies to the HLA molecule, when present, tended to react at a high fr equency on a random lymphocyte panel. These findings suggest that sens itization resulting in IgA anti-HLA antibodies may counteract the dele terious effect of an IgG antibody response in clinical kidney transpla ntation.