Analysis of Human Leukocyte Antigen Frequency among Renal Transplant Recipients and Donors in Nepal

Abstract

ABSTRACT Background and Objectives: Kidney transplants are effective for advanced renal failure, but graft rejection can occur when the recipient’s immune system misidentifies the kidney as a foreign object. Human leukocyte antigen (HLA), a component of the host’s immunological defense system, acts as a barrier to graft rejection. Selecting potential kidney recipients and donors for transplantation requires careful consideration of histocompatibility for the HLA-A, HLA-B, and HLA-DRB1 antigens. Mismatches between donors and recipients prolong transplant therapy, leading to lower graft survival and higher mortality. The objective of the study was to analyze HLA-A, HLA-B, and HLA-DRB1 antigens frequency in live-related renal transplant recipients and donors visiting the Department of Histocompatibility and Immunopathology at the National Public Health Laboratory, Teku, Kathmandu, Nepal. Methods: A retrospective study was conducted by using data from 104 renal transplant recipients and donors whose samples had previously been collected, processed, and analyzed to identify the Class I loci (HLA-A and HLA-B) and Class II loci (DRB1) between November 2021 and February 2024. Results: The study found that the majority of donors were female, and the majority of recipients were male. In this study, 10, 17, and 12 different HLA-A, B, and DRB1 alleles were found in recipients and donors. Alleles found more frequently are A*11 (25.00%), A*24 (23.08%), sB*15 (22.60%), B*35 (12.98%), DRB1*15 (22.60%), and DRB1*12 (21.63%). Conclusions: The study suggests that both donors and recipients of renal transplants in Nepal have a diverse HLA antigen distribution, which could aid in selecting a genetically closer group as potential matched donors for transplant recipients.