Development of an algorithm for risk of chronic antibody-mediated rejection after kidney transplant assessed by human leukocyte antigen structure-based histocompatibility

2020 Fiscal Year Final Research Report

• Project/Area Number: 18K09127
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 56030:Urology-related
• Research Institution: Jichi Medical University (2020); Hokkaido University (2018-2019)
• Principal Investigator: Iwami Daiki 自治医科大学, 医学部, 教授 (80581115)
• Co-Investigator(Kenkyū-buntansha): 大野 浩太 北海道大学, 大学病院, 特定専門職員 (10776016) ; 篠原 信雄 北海道大学, 医学研究院, 教授 (90250422) ; 堀田 記世彦 北海道大学, 大学病院, 講師 (90443936) ; 清水 俊洋 自治医科大学, 医学部, 講師 (40746575) ; 新里 高広 自治医科大学, 医学部, 助教 (00781303) ; 久保 太郎 自治医科大学, 医学部, 助教 (50508744) ; 木下 善隆 自治医科大学, 医学部, 助教 (30856282)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Keywords: 腎移植 / 慢性拒絶反応 / ヒト白血球抗原

Outline of Final Research Achievements

In this study, the number of mismatch eplets alone did not have a clear impact on the prognosis of transplanted kidneys. The reasons for this may be that the number of patients was not sufficient, the observation period was not long enough, and the immunosuppressive protocols have changed over the years, so the comparison under the same conditions was not possible. In addition, in the Japanese population, which has relatively low HLA diversity, there is little diversity in MM eplet numbers, and it may be difficult to show differences based on the mismatch eplets alone.
In the future, we will conduct risk stratification of CAMR based on the risk assessment of MM eplet numbers reported by various authors, use different immunosuppressive protocols accordingly, and prepare a study to launch a prospective study.

Free Research Field

腎移植

Academic Significance and Societal Importance of the Research Achievements

さらなる研究により、HLA構造解析に依拠した慢性拒絶反応リスク階層化により、患者個人個人の適正な免疫抑制プロトコールを適用し、副作用なく長期の生着を目指すことが可能になると思われる。