Effect of HLA-DP/HLA-DQ antibodies in renal transplantation v1.1
Research type
Research Study
Full title
Does the presence of donor specific antibodies to HLA-DP at the time of transplant effect graft outcome in renal patients?
IRAS ID
111026
Contact name
Shahram Hemmatpour
Contact email
Sponsor organisation
NHS Blood & Transplant
Research summary
This study sets out to establish the clinical evidence to support the Kidney Advisory Groups proposal that the Human Leucocyte Antigen DP should be included in the national kidney allocation scheme.
Thousands of patients have benefitted from receiving a donated kidney which has improved their quality of life and freed them from the reliance on dialysis. In addition, there are cost benefits to the National Health Service (NHS). The average cost of dialysis in the UK is £30,800 per patient per year with 3% of the NHS budget spend on kidney failure services. However, the cost of transplantation is £17,000 per patient with an additional £5,000 per year for immunosuppression. A NHS Blood and Transplant (NHSBT) factsheet on transplantation states ’in 2008-09, 2,497 people received a kidney transplant. These transplants are now saving the NHS £50.3m in dialysis costs each year for every year that the kidney functions’.
In the UK, the National Kidney Allocation scheme has up to now stated that the minimum resolution of Human Leucocyte Antigen (HLA) specificities for both donor offer types and patient registration types must include HLA-A, B, C, DR and DQ loci. However, recently the Kidney Advisory Group (KAG) (comprising medical consultants representing many of the renal transplant units, representatives from other transplant units, transplant co-ordinators and other interested groups) has proposed a national specification that states the minimum resolution for HLA typing should include HLA-DP even though the clinical evidence for extending the repertoire of HLA typing is contradictory in the literature.
This study will identify a cohort of transplanted renal patients from NHSBT laboratories that due to testing kit technology may have had undetected antibodies directed against donor HLA-DP antigens at the time of transplant. Statistical analysis will then be used to establish the clinical relevance of these antibodies.
REC name
North of Scotland Research Ethics Committee 2
REC reference
13/NS/0088
Date of REC Opinion
11 Jul 2013
REC opinion
Favourable Opinion