Longevity Project: HLA-DQ Immunogenicity – lessons learned from living-donor kidney transplant recipients with long-term allograft survival

Principal investigator: Anat R. Tambur, DMD, PhD, D(ABHI)
Co-investigator: Aleksandar Senev, MD, PhD, EBTI, F(ACHI)

Kidney transplantation is a life-saving gift to patients with kidney failure. Unfortunately, there are many more patients in need of kidney transplantation than potential donors (organs to be transplanted). A kidney for transplantation can be obtained either from a living- or a deceased donor. On average, kidneys donated by living donors benefit the recipient with higher transplant longevity.

Some patients may develop protein made in the body in response to foreign substance (antibodies) specific to cell surface molecules that are unique to the donor. These antibodies lead to antibody-mediated-rejection and are often associated with allograft loss. One of the ways to prevent this process from happening is to match between the recipient and the donor for those cell surface markers (called HLA antigens). However, finding a HLA matched donor limit the already small pool of potential donors, and thus matching is often not feasible.

Based on a previous study performed by our group, we have reason to believe that some HLA mismatches pose higher risk, while other mismatches can be reasonably tolerated under standard of care immunosuppressive medication. The current study is designed to validate these results. If our hypothesis is correct, then we can provide physicians better tools to determine which transplant recipients can benefit from safely lowering their level of immunosuppressive medication (and benefit from less side effects of these drugs). We can further inform organ allocation policies to direct deceased donor organs to those patients that are more likely to benefit from longer graft survival.