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Updated: Jun 24, 2026

Murine Renal Transplantation Procedure

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Published on: July 10, 2009

MICA compatibility and immunization in third kidney transplantations.

A Cesbron Gautier¹, A Devys, M L Cheneau

¹Laboratoire HLA-EFS, Nantes, France. anne.cesbron@efs.sante.fr

Transplantation Proceedings

|March 31, 2009

Summary

Third kidney transplants show lower survival, often due to high HLA matching despite similar rejection rates. This study investigated Major Histocompatibility Complex class I related chain A (MICA) alleles and MICA immunization in these patients.

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Area of Science:

Nephrology
Immunology
Transplantation Science

Background:

Third kidney transplant (G3) recipients exhibit significantly lower graft survival compared to first or second transplants.
G3 recipients are often highly Human Leukocyte Antigen (HLA) immunized, necessitating transplantation with high HLA matching.
Acute rejection rates in G3 recipients are comparable to those in first or second kidney transplants.

Purpose of the Study:

To investigate the role of Major Histocompatibility Complex class I related chain A (MICA) alleles and MICA immunization in third kidney transplant outcomes.
To determine the association between MICA mismatches and acute rejection or graft loss in G3 recipients.
To compare MICA immunization frequency with HLA immunization in this patient cohort.

Main Methods:

Typing of 43 donor-recipient pairs for MICA alleles using Luminex technology (LABtype RSSO).
Analysis of linkage disequilibrium between MICA alleles and the HLA B locus.
Assessment of MICA immunization in 52 patients using Luminex assay (LABScreen) with pre- and post-transplant sera.

Main Results:

Strong linkage disequilibrium observed between MICA alleles and the HLA B locus.
Higher frequency of MICA mismatches (2 MM) associated with rejection, while graft loss occurred in patients with 0 or 1 MICA MM.
MICA immunization was less frequent than HLA immunization; MICA donor-specific antibody (DSA) was present in both functional and failed grafts.

Conclusions:

MICA immunization may play a role in kidney transplant rejection, although it does not fully explain the poor graft survival in third transplants.
The observed graft survival in third kidney transplantations cannot be solely attributed to MICA incompatibility or immunization.
Further research is needed to elucidate the complex factors contributing to reduced graft survival in third kidney transplant recipients.