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. 2021 Mar 26;12:621138. doi: 10.3389/fimmu.2021.621138

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Copyright © 2021 Tomosugi, Iwasaki, Sakamoto, Niemann, Spierings, Nahara, Futamura, Okada, Hiramitsu, Takeda, Goto, Narumi, Watarai and Kobayashi

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Effect of the shared TEs on dnDSA formation. (A) Three-year-dnDSA-free graft survival in the non-DSA versus no anti-HLA antibody group. The Kaplan-Meier curves and Breslow test tend to show higher incidences of dnDSA in the early phase after transplantation in the non-DSA group than in the no anti-HLA antibody group, although this trend is not statistically significant (p = 0.08). The time to develop DSA after transplantation is statistically earlier in the non-DSA group than in the no anti-HLA antibody group (p = 0.01). (B) Three-year-dnDSA-free graft survival in the three groups: shared TE-positive, shared TE-negative, and no anti-HLA antibody group. The Kaplan-Meier curves and Breslow test show a significant difference between these groups (p = 0.001). The shared TE-positive group shows significantly higher incidences of dnDSA than the no anti-HLA antibody group (p = 0.001), while there is no statistically significant difference between the shared TE-negative group and no anti-HLA antibody group (p = 0.19). The time to develop DSA after transplantation is statistically earlier in the shared TE-positive group than in the no anti-HLA antibody group (p = 0.01). (C) Three-year-dnDSA-free graft survival in three groups: shared BE-positive, shared BE-negative, and no anti-HLA antibody group. The Kaplan-Meier curves and Breslow test show no significant difference between these groups (p = 0.19). The time to develop DSA after transplantation is statistically different between these groups (p = 0.03). *Multiple comparison results show statistical differences between only the shared BE-positive and no anti-HLA antibody group. dnDSA, de novo donor-specific anti-HLA antibodies; non-DSA, non-donor-specific anti-HLA antibodies; TE, T cell epitope; BE, B cell epitope; SD, standard deviation.