Functional Fc Gamma Receptor Gene Polymorphisms and Long-Term Kidney Allograft Survival

• Main Authors: Markus Wahrmann, Bernd Döhler, Marie-Luise Arnold, Sabine Scherer, Katharina A. Mayer, Susanne Haindl, Helmuth Haslacher, Georg A. Böhmig, Caner Süsal
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2021-08-01
• Series: Frontiers in Immunology
• Subjects: Fc gamma receptor; antibody-mediated rejection; kidney transplantation; anti-HLA antibodies; allograft survival
• Online Access: https://www.frontiersin.org/articles/10.3389/fimmu.2021.724331/full

The functional Fc gamma receptor (FcγR) IIIA polymorphism FCGR3A-V/F158 was earlier suggested to determine the potential of donor-specific HLA antibodies to trigger microcirculation inflammation, a key lesion of antibody-mediated renal allograft rejection. Associations with long-term transplant outcomes, however, have not been evaluated to date. To clarify the impact of FCGR3A-V/F158 polymorphism on kidney transplant survival, we genotyped a cohort of 1,940 recipient/donor pairs. Analyzing 10-year death-censored allograft survival, we found no significant differences in relation to FCGR3A-V/F158. There was also no independent survival effect in a multivariable Cox model. Similarly, functional polymorphisms in two other activating FcγR, FCGR2A-H/R131 (FcγRIIA) and FCGR3B-NA1/NA2 (FcγRIIIB), were not associated with outcome. There were also no significant survival differences among patient subgroups at increased risk of rejection-related injury, such as pre-sensitized recipients (> 0% panel reactivity; n = 438) or recipients treated for rejection within the first year after transplantation (n = 229). Our study results suggest that the earlier shown association of FcγR polymorphism with microcirculation inflammation may not be strong enough to exert a meaningful effect on graft survival.