Medknow Publications on behalf of Indian Society of Human Genetics
Abstract
Background:During the last five years the proportion of living
unrelated kidney transplants has increased and DNA tissue-typing
methods have become popular in India. This study was carried out to
compare the results of tissue - typing by serology and sequence
specific primers (SSP) and study the usefulness of 'episode' allograft
biopsies for diagnosis of acute graft dysfunction. Materials and
Methods:DNA was extracted from whole blood using Qiagen kit. Samples
from 60 individuals including thirty patients and their donors were
typed by serology and SSP. Fifteen allograft biopsies were performed
for suspected acute rejection (AR) cases. Results: Both alleles of HLA
- A, B and DR antigen could be determined in 86, 65 and 90% of samples
by SSP respectively. There was a discrepancy of 16-40% between SSP and
serology. Acute rejection was confirmed in 8/15 biopsies. Graft
survival rates were 83 and 76% at one and two years respectively.
Neither the graft survival nor the number of AR episodes showed any
correlation with the extent of HLA mismatch. SSP was useful in defining
A*68, A*66, A*69 and A*33 alleles at private level and A*36, A*74 and
A*03 alleles which were blank on serology. Conclusions: SSP has become
popular in India due to its simplicity, superior results especially for
class II HLA alleles: and episode allograft biopsy is adequate for
follow-up of kidney recipients