RT info:eu-repo/semantics/article T1 Impact of HLA Mismatching on Early Subclinical Inflammation in Low-Immunological Risk Kidney Transplant Recipients A1 Hernández Marrero, Domingo Jerónimo A1 Vázquez, Teresa A1 Alonso Titos, Juana A1 León, Myriam A1 Caballero, Abelardo A1 Cobo, María Ángeles A1 Sola, Eugenia A1 López, Verónica A1 Ruíz Esteban, Pedro A1 Cruzado, Josep María A1 Sellarés, Joana A1 Moreso, Francesc A1 Manonelles, Anna A1 Torio, Alberto A1 Cabello, Mercedes A1 Delgado Burgos, Juan A1 Casas, Cristina A1 Gutiérrez, Elena A1 Jironda, Cristina A1 Kanter, Julia A1 Serón, Daniel A1 Torres, Armando A2 Medicina InternaDermatología y Psiquiatría K1 kidney transplantation K1 HLA compatibility K1 subclinical inflammation K1 Banff criteria K1 low-immunological risk AB The impact of human leukocyte antigen (HLA)‐mismatching on the early appearance of subclinical inflammation (SCI) in low‐immunological‐risk kidney transplant (KT) recipients is undetermined. We aimed to assess whether HLA‐mismatching (A‐B‐C‐DR‐DQ) is a risk factor for early SCI. As part of a clinical trial (Clinicaltrials.gov, number NCT02284464), a total of 105 low-immunological‐risk KT patients underwent a protocol biopsy on the third month post‐KT. As a result, 54 presented SCI, showing a greater number of total HLA‐mismatches (p = 0.008) and worse allograft function compared with the no inflammation group (48.5 ± 13.6 vs. 60 ± 23.4 mL/min; p = 0.003). Multiple logistic regression showed that the only risk factor associated with SCI was the total HLA‐mismatch score (OR 1.32, 95%CI 1.06–1.64, p = 0.013) or class II HLA mismatching (OR 1.51; 95%CI 1.04–2.19, p = 0.032) after adjusting for confounder variables (recipient age, delayed graft function, transfusion prior KT, and tacrolimus levels). The ROC curve illustrated that the HLA mismatching of six antigens was the optimal value in terms of sensitivity and specificity for predicting the SCI. Finally, a significantly higher proportion of SCI was seen in patients with >6 vs. ≤6 HLA‐mismatches (62.3 vs. 37.7%; p = 0.008). HLA compatibility is an independent risk factor associated with early SCI. Thus, transplant physicians should perhaps be more aware of HLA mismatching to reduce these early harmful lesions. YR 2021 FD 2021 LK http://riull.ull.es/xmlui/handle/915/40237 UL http://riull.ull.es/xmlui/handle/915/40237 LA en DS Repositorio institucional de la Universidad de La Laguna RD 03-ene-2025