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Case Reports
. 2001 Dec 15;72(11):1851-3.
doi: 10.1097/00007890-200112150-00027.

The clinical importance of variation within the HLA-Bw4 complex

R W Collins  1 , A W Harmer, A J Heads, E Kondeatis, G Page, R W Vaughan
Affiliations
Case Reports

The clinical importance of variation within the HLA-Bw4 complex

R W Collins et al. Transplantation. .

Abstract

Background: Antibody screening of a patient with a failed renal transplant showed positive reactions with most, but not all HLA-Bw4-associated B-locus antigens. However, the patient's serological HLA class I type suggested the presence of HLA-Bw4.

Methods: Standard molecular techniques were used to re-type the patient and donor. ELISA antibody screening helped determine the patient's antibody specificity.

Results: The patient's type was HLA-B*1402,4703;Bw6 and the donor HLA-B*4703,51011;Bw4,6. Analysis of ELISA results identified three amino acids (positions 77,80,81) as the most likely epitope recognised by the patient's serum. These corresponded to HLA-B*51011 amino acid mismatches, explaining the lymphocytotoxic reactivity pattern. This epitope is located on a subgroup of the HLA-Bw4 antigen suggesting anti-Bw4 was not a sufficient description of this antibody.

Conclusions: This report identifies an antibody to a sub-group of the Bw4 public specificity and also confirms the need for sequence-level analysis in the tissue-typing laboratory to determine future unacceptable mismatches.

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