Background: Human leukocyte antigen (HLA)-DPB1 T-cell epitope (TCE) mismatches have been studied in the context of graft-versus-host disease (GVHD) in hematopoietic cell transplantation (HCT). HLA-DPB1 TCE-nonpermissive mismatches have been associated with improved overall survival in HCT. However, the impact of HLA-DPB1 incompatibility on the outcomes of kidney transplantation is not fully understood.
Methods: We conducted a retrospective analysis of 31 patients who received a kidney transplant and had available donor and recipient HLA-DPB1 high-resolution typing. HLA-DPB1 mismatches based on TCE were determined using the DPB1 T-Cell Epitope Algorithm 2.0 (www.ebi.ac.uk).
Results: The follow-up period ranged from 7 to 183 days after transplantation. Normal creatinine levels (<1.19 mg/dL) were observed in 19 recipients (61.3%). The remaining 6 recipients had creatinine levels below 2.5 mg/dL. HLA-DPB1 TCE-nonpermissive mismatches were identified in 6 (19.4%) of the patients. The odds of having abnormal creatinine levels after transplantation were significantly higher in patients with HLA-DPB1 TCE-nonpermissive mismatches compared to patients with HLA-DPB1 TCE-permissive mismatches (odds ratio 14.0, 95% CI 1.3 to 137.6).
Conclusions: Our study suggests that HLA-DPB1 TCE-nonpermissive mismatches may be a factor that affects the prognosis after kidney transplantation. However, longer follow-up periods and studies with larger patient numbers are needed to confirm these findings.