Do the blood groups and HLA types have a role in end stage chronic renal failure pathogenesis? A comparative retrospective single-center study
Ugur Musabak1, Didem Turgut2, Cihad Burak Sayin2, Turan Colak2, Emre Karakaya3, Mehmet A. Haberal3.
1Immunology, Baskent University, Ankara, Turkey; 2Nephrology, Baskent University, Ankara, Turkey; 3Transplantation, Baskent University, Ankara, Turkey
Objective: The aim of this study was to investigate the distribution of blood groups and HLA types in patients with end stage chronic renal failure (ESCRF) following in our transplant center and their living donor candidates.
Materials and Methods: We performed a retrospective analysis based on 2698 cases’ results registered in our center between July 01, 2011 and February 15, 2020. The study groups were composed of 1798 kidney recipients and 900 living donors. HLA typing for -A, -B, -C, -DQ and -DR loci were done by using polymerase chain reaction with sequence specific primers (PCR-SSP) low-resolution methods. SPSS (SPSS 11.5, SPSS Inc., Chicago, IL, USA) statistical package was used for statistical analyses.
Results: Male gender dominance was determined in the recipient group and female gender dominance was found in the donor group (p<0.01).While “A” blood group was statistically more frequent in recipients than those of donor candidates, “0” blood group frequency was significantly higher in donor candidates than those of recipients (p<0.001). Similarly, significant “ARh+” dominance was observed in recipients but “0Rh+” dominance in donor candidates (p<0.001). According to frequencies, first six HLA alleles at Class-I “A” locus and Class-I “B” locus were same and ordered as HLA-A*02>-A*24>-A*03>-A*01>-A*11>-A*26; HLA-B*35>-B*51>-B*44>-B*18>B*38>B*07 in both recipients and donor candidates, respectively. The most frequent HLA allele at Class-I “C” locus was -C*07 in recipients, but -C*04 in donor candidates. There was an exact opposite situation in these alleles for the second alleles at the same locus. The other four alleles were respectively ordered as HLA-C *12>-C*06>-C*15>-C*03 in both recipients and donor candidates. While first six HLA allele at Class II “DR” locus was same as HLA-DRB1*11>-DRB1*04>-DRB1*13>-DRB1*15>-DRB1*03>-DRB1*07 and first five HLA allele at Class II “DQ” locus was same as HLA-DQB1*03>-DQB1*05>-DQB1*06>-DQB1*02>-DQB1*04 in both groups. In both study groups, most frequent genotype was same in all HLA loci, except “C” locus. In addition, first six HLA genotypes at Class-I “B” locus were same and ordered as HLA-B*35:51>-B*35:35>-B*51:51>-B*35:44>-B*18:35>-B*18:51. Although there are some subtle differences between distribution of HLA alleles, genotypes, and haplotypes detected in recipients and donor candidates, these are not significantly different from each other.
Conclusion: The insignificant differences observed in distribution of HLA types between recipients and donor candidates support that there is not a considerable relationship between HLA types and ESCRF. However, significant differences shown in distribution of blood groups between recipients and donor candidates evidence the role of ABO system in pathogenesis of ESCRF.
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