M. L. ArnoldC. BachF. M. HeinemannP. A. HornM. ZiemannN. LachmannA. MühlbacherA. DickA. EnderD. ThammanichanondS. SchaubG. HöngerG. F. FischerJ. MytilineosM. HallenslebenW. E. HitzlerC. SeidlB. M. SpriewaldKlinikum Stuttgart KatharinenhospitalUniversity of Basel, Institute for Medical MicrobiologyUniversitätsklinik Erlangen und Medizinische FakultätCharité – Universitätsmedizin BerlinMedizinische Hochschule Hannover (MHH)Klinikum der Johannes-Gutenberg-Universität und Fachbereich MedizinUniversity Hospital InnsbruckMahidol UniversityMedizinische Universitat WienUniversitätsklinikum UlmUniversitäts Klinikum Essen und Medizinische FakultätUniversitätskliniken Schleswig-HolsteinKlinikum der Universität MünchenInstitute for Transfusion Medicine and Immunohaematology2019-08-232019-08-232018-06-01International Journal of Immunogenetics. Vol.45, No.3 (2018), 95-1011744313X174431212-s2.0-85044380417https://repository.li.mahidol.ac.th/handle/20.500.14594/45159© 2018 The Authors. International Journal of Immunogenetics Published by John Wiley & Sons Ltd. We reported previously on the widespread occurrence of anti-HLA alloantibodies of the IgA isotype (anti-HLA IgA) in the sera of solid-organ re-transplantation (re-tx) candidates (Arnold et al.,). Specifically focussing on kidney re-tx patients, we now extended our earlier findings by examining the impact of the presence and donor specificity of anti-HLA IgA on graft survival. We observed frequent concurrence of anti-HLA IgA and anti-HLA IgG in 27% of our multicenter collective of 694 kidney re-tx patients. This subgroup displayed significantly reduced graft survival as evidenced by the median time to first dialysis after transplantation (TTD 77 months) compared to patients carrying either anti-HLA IgG or IgA (TTD 102 and 94 months, respectively). In addition, donor specificity of anti-HLA IgA had a significant negative impact on graft survival (TTD 74 months) in our study. Taken together, our data strongly indicate that presence of anti-HLA IgA, in particular in conjunction with anti-HLA-IgG, in sera of kidney re-tx patients is associated with negative transplantation outcome.Mahidol UniversityBiochemistry, Genetics and Molecular BiologyImmunology and MicrobiologyMedicineArticleSCOPUS10.1111/iji.12363