Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 16 3 2017 06 17 245 255 EN Davood Jafari Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Mohsen Nafar Chronic Kidney Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mir Saeed Yekaninejad Department of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Razieh Abdolvahabi Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Mahboob Lesan Pezeshki Nephrology Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Efat Razaghi Urology Resarch Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Ali Akbar Amirzargar Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran AND Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran 2016 06 03 2016 09 05 After kidney transplantation, natural killer (NK) cells play a pivotal role in triggering the immune response to the allogeneic grafts primarily by their killer-cell immunoglobulin-like receptors (KIR). This process may be one mechanism that contributes to graft rejection. In this study, we have evaluated whether acute rejection after kidney transplantation was associated with predicted NK cell alloreactivity based on KIR gene and ligand along with KIR/HLA compound genotype analysis. After kidney transplantation, natural killer (NK) cells play a pivotal role in triggering the immune response to the allogeneic grafts primarily by their killer-cell immunoglobulin-like receptors (KIR). This process may be one mechanism that contributes to graft rejection. In this study, we have evaluated whether acute rejection after kidney transplantation was associated with predicted NK cell alloreactivity based on KIR gene and ligand along with KIR/HLA compound genotype analysis. DNA from 65 patients with biopsy-proven acute kidney allograft rejection (AKAR), 61 clinically stable graft function (SGF) recipients and 176 healthy subjects were identified for the presence or absence of 10 variable KIR genes (both activating and inhibitory receptors) and their HLA ligands using polymerase chain reaction-sequence specific primers (PCR-SSP) assay. Although no significant difference in the frequency of individual KIR genes, was found the gene content, and the haplotypic distribution between the three categories were detected, the frequency of the KIR3DL1+HLA-Bw4*A allele combination was significantly lower in AKAR patients compared to SGF recipients (p=0.004, OR=0.34, CI=0.16-0.72) and healthy subjects (p=0.019, OR=0.47, CI=0.25-0.89). Kaplan-Meier survival test showed that the KIR3DL1+HLA-Bw4*A allele combination could be considered protective for AKAR (p=0.04 by log-rank). The results of this study suggest that KIR/HLA polymorphism may be a genetic susceptibility factor to alloreactivity dysfunction in the NK cells of patients with AKAR. It is likely that a KIR/HLA combinatorial study can be beneficial in predicting AKAR occurrence for the purpose of selecting donors appropriately. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/944 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/944/746