Re-evaluation of Donor-specific Anti-HLA Alloantibodies Immunoassay After Organ Transplantation, From Antigen Level to Epitope Level (ACORG-HLA)
Re-evaluation of Donor-specific Anti-HLA Alloantibodies Immunoassay After Organ Transplantation, From Antigen Level to Epitope Level: a Track to Improve Organ Allocation
Transplantation is the only treatment for end-stage organ dysfunction, with dialysis for the kidney. However, donor / recipient (D / R) tissue incompatibility accounts for the majority of long-term graft losses, through the development of serum-specific donor antibodies (DSA) to human leukocyte antigens (HLA) of donor, with a prevalence of about 10% at 2 years and 20% at 5 years.
DSA immunization is very often directed against one or a few of the donor's incompatible antigens, suggesting that epitopes (and antigens) are not all equally immunogenic. Identifying HLA epitopes that cause the most and the least immunization would help refine the graft distribution to better manage a limited resource by defining the D / R combinations to avoid or promote. Since the immunogenicity of an HLA epitope depends on the HLA of the recipient given the properties of the epitopes mentioned above, a very large cohort is needed to understand this question. To do so, it is necessary to redo these typings with a method exploring all the genes (add DQA1, DRB3 / 4/5, DPB1 and DPA1) when this has not been done after the graft as part of the standard care. This has become possible since 3 years by DNA sequencing called "new generation" (or NGS), a method that is supplanting all others for the medical care of patients in transplantation.
This study is a retrospective cohort study with 5-year follow-up. The investigators' main objective is to evaluate the predictive value of the number of mismatched HLA epitopes for the development of DSA anti-HLA de novo at 2 years. The investigators' secondary objectives are to evaluate this parameter at 5 and 8 years to determine which epitope mismatches should be favored / avoided in the future.
調査の概要
研究の種類
入学 (予想される)
連絡先と場所
研究連絡先
- 名前:Jean-Luc TAUPIN, Pr
- 電話番号:+331 42 49 90 81
- メール:jean-luc.taupin@aphp.fr
研究連絡先のバックアップ
- 名前:Sylvie Chevret, Pr
- 電話番号:+33142499742 +33142499742
- メール:sylvie.chevret@paris7.jussieu.fr
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- patients (adults and children)
- patients recipients in France from 2008 to 2015 of a first kidney transplant / heart / lung / liver donor living or deceased, non-immunized anti-HLA before the transplant
- patients having preserved their graft > 2 years
- having agreed to the use for research purposes in transplantation of the remains of the DNA and serum samples taken as part of the care of which the remains are available
Exclusion Criteria:
- no inclusion if one of the inclusion criteria is not met
研究計画
研究はどのように設計されていますか?
デザインの詳細
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Proportion of serum-specific donor antibodies (DSA)
時間枠:at 2 years after organ transplantation
|
Proportion of serum-specific donor antibodies (DSA) regarding epitope mismatches
|
at 2 years after organ transplantation
|
二次結果の測定
結果測定 |
時間枠 |
---|---|
Proportion of dnDSA anti-HLA
時間枠:at 2 years after organ transplantation
|
at 2 years after organ transplantation
|
Proportion of dnDSA anti-HLA
時間枠:at 5 years after organ transplantation
|
at 5 years after organ transplantation
|
Proportion of dnDSA anti-HLA
時間枠:at 8 years after organ transplantation
|
at 8 years after organ transplantation
|
Proportion of non-DSA anti-HLA antibodies
時間枠:at 2 years after organ transplantation
|
at 2 years after organ transplantation
|
Proportion of non-DSA anti-HLA antibodies
時間枠:at 5 years after organ transplantation
|
at 5 years after organ transplantation
|
Proportion of non-DSA anti-HLA antibodies
時間枠:at 8 years after organ transplantation
|
at 8 years after organ transplantation
|
Proportion of both total and HLA class I or class II dnDSA by HLA locus (A, B, C, DRB1, DRB3 / 4/5, DQB1, DQA1, DPB1, DPA1) , by HLA antigen, by epitope, for all types of organs and by organ type
時間枠:at 2 years after organ transplantation
|
at 2 years after organ transplantation
|
Proportion of both total and HLA class I or class II dnDSA by HLA locus (A, B, C, DRB1, DRB3 / 4/5, DQB1, DQA1, DPB1, DPA1) , by HLA antigen, by epitope, for all types of organs and by organ type
時間枠:at 5 years after organ transplantation
|
at 5 years after organ transplantation
|
Proportion of both total and HLA class I or class II dnDSA by HLA locus (A, B, C, DRB1, DRB3 / 4/5, DQB1, DQA1, DPB1, DPA1) , by HLA antigen, by epitope, for all types of organs and by organ type
時間枠:at 8 years after organ transplantation
|
at 8 years after organ transplantation
|
Number of dnDSA anti-HLA both total and by HLA class (class I versus class II), by HLA locus (A, B, C, DRB1, DRB3 / 4/5, DQB1, DQA1, DPB1, DPA1), by HLA antigen, for all organ types and organ type
時間枠:at 2 years after organ transplantation
|
at 2 years after organ transplantation
|
Number of dnDSA anti-HLA both total and by HLA class (class I versus class II), by HLA locus (A, B, C, DRB1, DRB3 / 4/5, DQB1, DQA1, DPB1, DPA1), by HLA antigen, for all organ types and organ type
時間枠:at 5 years after organ transplantation
|
at 5 years after organ transplantation
|
Number of dnDSA anti-HLA both total and by HLA class (class I versus class II), by HLA locus (A, B, C, DRB1, DRB3 / 4/5, DQB1, DQA1, DPB1, DPA1), by HLA antigen, for all organ types and organ type
時間枠:at 8 years after organ transplantation
|
at 8 years after organ transplantation
|
Distribution of anti-HLA dnDSA by targeted epitope and antigen (to define immunodominant and non-immunodominant epitopes and antigens), both total and by HLA class (class I versus class II), by HLA locus for all types of organs and organ type
時間枠:at 2 years after organ transplantation
|
at 2 years after organ transplantation
|
Distribution of anti-HLA dnDSA by targeted epitope and antigen (to define immunodominant and non-immunodominant epitopes and antigens), both total and by HLA class (class I versus class II), by HLA locus for all types of organs and organ type
時間枠:at 5 years after organ transplantation
|
at 5 years after organ transplantation
|
Distribution of anti-HLA dnDSA by targeted epitope and antigen (to define immunodominant and non-immunodominant epitopes and antigens), both total and by HLA class (class I versus class II), by HLA locus for all types of organs and organ type
時間枠:at 8 years after organ transplantation
|
at 8 years after organ transplantation
|
Distribution of strength anti-HLA dnDSA measured by mean fluorescence intensity to identify the immunodominant DSA, both global and by class, by HLA locus by HLA antigen, by epitope, for all types of organs and organ type
時間枠:at 2 years after organ transplantation
|
at 2 years after organ transplantation
|
Distribution of strength anti-HLA dnDSA measured by mean fluorescence intensity to identify the immunodominant DSA, both global and by class, by HLA locus by HLA antigen, by epitope, for all types of organs and organ type
時間枠:at 5 years after organ transplantation
|
at 5 years after organ transplantation
|
Distribution of strength anti-HLA dnDSA measured by mean fluorescence intensity to identify the immunodominant DSA, both global and by class, by HLA locus by HLA antigen, by epitope, for all types of organs and organ type
時間枠:at 8 years after organ transplantation
|
at 8 years after organ transplantation
|
Strength in mean fluorescence intensity of dnDSA anti-HLA de novo specific epitopes of epitopes DQbeta, DQalpha and composites (DQbeta + DQalpha) by antigen DQ
時間枠:at 2 years after organ transplantation
|
at 2 years after organ transplantation
|
Strength in mean fluorescence intensity of dnDSA anti-HLA de novo specific epitopes of epitopes DQbeta, DQalpha and composites (DQbeta + DQalpha) by antigen DQ
時間枠:at 5 years after organ transplantation
|
at 5 years after organ transplantation
|
Strength in mean fluorescence intensity of dnDSA anti-HLA de novo specific epitopes of epitopes DQbeta, DQalpha and composites (DQbeta + DQalpha) by antigen DQ
時間枠:at 8 years after organ transplantation
|
at 8 years after organ transplantation
|
Survival of the graft
時間枠:at 5 years after organ transplantation
|
at 5 years after organ transplantation
|
Survival of the graft
時間枠:at 8 years after organ transplantation
|
at 8 years after organ transplantation
|
Overall survival
時間枠:at 5 years after organ transplantation
|
at 5 years after organ transplantation
|
Overall survival
時間枠:at 8 years after organ transplantation
|
at 8 years after organ transplantation
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (予想される)
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
- NI16035HLJ
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