Determination of mismatched donor HLA in kidney transplant recipients with unknown donor HLA phenotypes.

Objective: To determine donor human leukocyte antigen (HLA) from renal allograft biopsies in transplant recipients whose donor HLA phenotype is not known.

Methods: Renal allograft biopsies were obtained from seven renal transplant recipients when indicated for allograft dysfunction or proteinuria. DNA was extracted fresh from allograft specimens, and HLA typing was performed with polymerase chain reaction-specific sequence primers (PCR-SSP) and polymerase chain reaction-sequence-specific oligonucleotides (PCR-SSO).

Results: HLA typing of the seven renal allograft biopsies was composed of both recipient and donor HLA phenotypes, allowing the determination of the donor HLA and the degree of HLA mismatching.

Conclusions: Deducing mismatched donor HLA antigens in renal allograft recipients enables detection of donor-specific antibodies, and the management of humoral rejection, and enables more appropriate selection of a donor organ should future retransplantation be required.