Maternal Tissue Typing Could Improve Selection Of Kidney Transplant Donors

December 04, 1998

Researchers supported by the National Institutes of Health (NIH) have discovered that cellular markers, or human leukocyte antigens (HLA), on maternal tissue can provide valuable information for identifying the most suitable donors for individuals in need of kidney transplants. The new finding was reported Dec. 3, 1998, in The New England Journal of Medicine by a team of scientists led by William J. Burlingham, Ph.D., of the University of Wisconsin, Madison, and Michael A. Bean, M.D., of Dendreon Corporation, Mountain View, Calif.

"The simple addition of maternal HLA typing," says Dr. Burlingham, "to the routine family workup for living-related kidney donation will greatly expand the pool of optimal donors, by giving an alternative choice to the transplant surgeon in cases where an HLA-identical sibling is unavailable. Based on this finding, the University of Wisconsin plans to add maternal HLA typing to their pre-transplantation procedures."

To minimize the risk of transplant rejection, surgeons try to find donors who are genetically similar to the recipient. The best outcomes are achieved when the donor is the identical twin of the individual who needs a transplant. In the absence of an identical twin, other siblings, such as those who share identical HLA genes, usually provide the closest HLA match.

Dr. Burlingham’s research team compared transplant survival rates of kidneys donated by HLA-identical siblings of recipients with those donated by siblings who shared only half of the recipients’ HLA antigens. The researchers found that long-term survival rates of HLA-identical kidneys were the same as HLA-mismatched kidneys, provided the donors’ mismatched HLA antigens were inherited from the siblings’ mother rather than their father. Therefore, comparing the mother’s HLA type with those of the transplant candidate’s siblings will provide clues about which sibling would be the optimal organ donor.

The researchers hypothesize that prenatal exposure to maternal HLA molecules induces a long-lasting form of immune tolerance. Thus, when the recipient encounters the same HLA molecules in adult life via a sibling-donated kidney, this state of induced immune tolerance prevents rejection of the mismatched kidney.

"Finding ways to induce immune tolerance to foreign tissue is the ‘Holy Grail’ of transplantation researchers," notes Steve Rose, Ph.D., chief of NIAID’s genetics and transplantation branch. "This study could provide important new insights into mechanisms of immune tolerance."

This study was supported by grants from the National Institute of Allergy and Infectious Diseases (NIAID) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

WJ Burlingham, AP Grailer, DM Heisey, FHJ Claas, D Norman, T Mohanakumar, DC Brennan, H DeFijter, T VanGelder, JD Pirsch, HW Sollinger and MA Bean. The effect of tolerance to noninherited maternal HLA antigens on the survival of renal transplants from sibling donors. NEJM 339, 1657-64 (1998).

F Sanfilippo. Transplantation tolerance - the search continues (editorial). NEJM 339, 1700-02 (1998).

NIH/National Institute of Allergy and Infectious Diseases

Related Siblings Articles from Brightsurf:

Stars and planets grow up together as siblings
ALMA shows rings around the still-growing proto-star IRS 63

Study of siblings finds moderate cannabis use impacts cognitive functioning
A new study led by researchers from the University of Colorado School of Medicine compares adolescent siblings to determine the impact of early and frequent use of marijuana on cognitive function.

Child disability can reduce educational outcomes for older siblings
A recent paper published in The Economic Journal indicates that, in families with disabled children, the second born child is more adversely affected cognitively than the first-born child.

Siblings of children with intellectual disabilities score high on empathy and closeness
A new Tel Aviv University and University of Haifa study finds that relationships between children and their siblings with intellectual disabilities are more positive than those between typically developing siblings.

Genome testing for siblings of kids with autism may detect ASD before symptoms appear
One of the key priorities of interventions for autism spectrum disorder (ASD) is starting early, with some evidence showing infants as young as seven months old could benefit.

New study debunks myth that only children are more narcissistic than kids with siblings
The stereotype that only children are selfish, or more self-centered than those with siblings is sometimes used as an argument for having more than one child, but researchers from Germany find there's no evidence for the claim that only children are more narcissistic than children with sibling.

Children bullied by friends and siblings are more likely to think about suicide in their early 20s
Depression, self-harm and suicidal ideation are more prominent in adults in their early twenties if they were bullied at home and at school, a study by researchers at the University of Warwick have found.

UBC study finds siblings of problem gamblers also impulsive, prone to risk-taking
Biological siblings of people with gambling disorder also display markers of increased impulsivity and risk-taking, according to a new UBC psychology study.

Québec siblings with rare orphan disease lead to discovery of rare genetic diseases
Mutations in a gene involved in brain development have led to the discovery of two new neurodevelopmental diseases by an international team led by researchers at McGill University and CHU Sainte-Justine Research Center.

The more the merrier? Children with multiple siblings more susceptible to bullying
A child with more than one brother or sister is more likely to be the victim of sibling bullying than those with only one sibling, and firstborn children and older brothers tend to be the perpetrators, according to research published by the American Psychological Association.

Read More: Siblings News and Siblings Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to