Role of HLA Antobodies Class I and II and infections among Renal Transplantion

Abstract

newlineChronic kidney disease is iceberg in the world, particularly in developing countries. Progressive newlinechronic kidney disease leads to end-stage renal disease. The end-stage renal disease occurs when newlinethe kidneys are no longer able to function at a level that is necessary for day-to-day life. Either newlinedialysis or kidney transplant is the mode of treatment. There is an acute need to increase kidney newlinetransplant to offer a better life to end-stage renal disease patients. Access to dialysis and kidney newlinetransplant in the developing world is limited because of a shortage of organ, affordability and newlinevery expensive treatment for a lifetime. Hence, optimizing renal allograft survival is essential. newlineHealth care between urban and rural populations is different due to disparities in wealth and newlineliteracy. The most common causes of kidney disease in India in both men and women are newlinediabetes and hypertension. This study aimed to evaluate clinical outcomes and identify poor newlineprognostic factors in the renal transplant at the institute of kidney diseases and research center newline(IKDRC), Ahmedabad. Antibody-mediated and viral infections lead to rejection. The rationale newlineof the present study was to understand the different mechanisms involved in the molecular newlinepathways of rejections. The study was designed with two main objectives in mind to understand newlinethe causes of rejections in spite of best HLA matching. Also, there is a need to address problems newlineinvolved in kidney transplants like morbidity, rejections, infections and long term survival of the newlinegraft newline1) To correlate the presence of class-I and class-II antibodies with rejection episodes. newline2) To correlate viral infection with rejections. newlineIt has been pointed out that the presence of donor-specific antibodies (DSA) in ESRD cases are newlineseen in high-risk patients. Inadequate immunosuppression and non-adherence lead to graft newlinerejection. Denovo DSAs are predominantly directed to donor HLA (human leukocyte antigen) newlineclass II mismatches and usually occur during the first year of a kidney transplant, but