Next-generation sequencing for deducing donor mismatched human leukocyte antigen typing from urine of kidney transplant recipients: abridged secondary publication
JCY Ho1; LCW Choi1; SLK Ng1; SKF Cheung1; SKS Fung2; AKC Hau3; CB Leung4; WL Chak5; SK Mak6; JSY Kwok1
1 Division of Transplantation and Immunogenetics, Queen Mary Hospital
2 Jockey Club Nephrology and Urology Centre, Princess Margaret Hospital
3 Department of Medicine and Geriatrics, Tuen Mun Hospital
4 Division of Nephrology, Department of Medicine and Therapeutics, Prince of Wales Hospital
5 Department of Medicine, Queen Elizabeth Hospital
6Department of Medicine and Geriatrics, Kwong Wah Hospital
1. Donor human leukocyte antigen (HLA) typing is crucial for the diagnosis of antibody-mediated rejection. It facilitates prompt medical intervention to salvage the graft from failure. Recipients' urine sample is proven to be a valuable non-invasive source for the deduction of donor HLA typing.
2. Next-generation sequencing (NGS) can help resolve the donor mismatched HLA typing at high resolution and reveal additional HLA loci that were not determined during transplant workup.
3. The NGS protocol can complement the polymerase chain reaction–single specific primer method to determine the presence of donor-specific antibody and define the specificity of donor typing at allelic level.
4. Loss of donor chimerism in recipient urine sample was associated with failure in detecting donor HLA allele by NGS.
5. Further optimisation of donor DNA quantity, amplification, and NGS data analysis is warranted to enhance the detection of donor DNA material in recipient urine sample.