HLA system features in patients on waiting list for kidney transplantation in the Republic of Bashkortostan

The aim of our study was to specify the features of the HLA system in patients registered on the waiting list for kidney transplantation in the Republic of Bashkortostan. HLA-A, HLA-B, and HLA-DR phenotypes were assayed by polymerase chain reaction using PROTRANS and OLERUP SSP kits. The frequency of antigen occurence was determined as the percentage of individuals with the given antigen to the total number of examined individuals. To determine the patterns of distinct antigens within various HLA combinations, we determined maximal percentage of the antigen frequency in combination with other HLA. The largest number of patients on the waiting list suffered from chronic glomerulonephritis, followed by diabetes mellitus, chronic interstitial nephritis, chronic pyelonephritis and polycystic kidney disease. The occurrence frequency of various HLA and their combinations was established both among all the patients suffering from stage 5 chronic kidney disease, and among patients with regard to each nosological category, and the patterns of various HLA combinations were established. The data obtained have been compared with the study results of patients from the waiting lists for organ transplantation in other regions. HLA-A02 (similar to Brazil, Great Britain), HLA-DR07, HLA-DR04 (like as in Nepal, European population of Kazakhstan, Southern China), HLA-A24 (as in Nepal, Southern China), and combinations of HLA-A02-A03, HLA-A02-DR04, HLA-A02-DR01, HLA-A02-B07, HLA-A03-DR01, HLA-B35-DR01 were most common in the patients with chronic kidney disease which can be considered as risk factor for severe nephropathy. HLA-B15, HLA-B40, HLA-vA30, HLA-A32, HLA-B56, HLA-B60, HLA-DR10 were found at minimal frequency; as well as the following combinations: HLA-A01-A24-B08-DR17, HLA-A01-A68-DR07, HLAA24-B07-B13, HLA-A01-B08-B13, HLA-A02-B35-B38-DR01, HLA-A02-B50-B61-DR07, HLA-A01-B55-DR04, HLA-A02-B55-DR03, HLA-A24-B55-DR13, HLA-A01-A02-B08-DR03, HLA-A02-DR01-DR13. The following antigens were absent among our patients: HLA-A28 (similar to Kuwait); HLA-A11, HLA-A23, HLA-A28, HLA-A33, HLA-B46, HLA-B62;-DR03, HLA-DR14 (as in Kazakhstan); HLAA19, HLA-A43, HLA-B16, HLA-B21, HLA-B22, HLA-B83 and HLA-DR05 (as in Great Britain); HLAB14 (as in Brazil). The results obtained were either similar, or different from the literature data, both in terms of the most common HLA and their combinations with regard of special nephropathy types. The revealed differences can be explained by presence of population-specifical HLA features in the patients from different ethnic groups and living in different geographical areas. The found stable associative links between the disorders and HLA may contribute to better understanding of pathogenesis of the disorders, their early preclinical detection, evaluating risk for development of pathological conditions, thus allowing timely justification of preventive measures.

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