Abstract
Organ transplantation is the treatment in patients with organ failure where kidney is the organ with the highest rate of transplantation in Thailand. Despite 50 years of an advancement in transplant surgical techniques and post-transplantation care, long-term kidney graft survival is not changed. One of the factor would be that the HLA matching technique used is polymerase chain reaction-sequence specific oligonucleotide (PCR-SSO, Luminex®) which has intermediate resolution for detecting variations in HLA gene. We conducted a HLA sequencing of 330 kidney transplant donors and recipients using Long-Read Single Molecule Real-Time (SMRT) Sequencing and observed the significant association of HLA long-read mismatch score to any type of rejection at 1 year post transplantation and any episode of graft rejection from transplantation to year 2021. This association was better than HLA Luminex mismatch score calculated with PCR-SSO technique. The HLA long-read sequencing information obtained from this study can be used as a reference allele for Thai population. There should be more population sequenced with HLA-long read technique to enhance robustness of the reference database. A prospective multicenter study comparing allocation of donor-recipients with HLA Luminex score versus HLA long-read score is warranted to evaluate outcomes such as death or allograft failure which were not be able to assessed in this study.
