Introduction The purpose of this study was to determine the predictive and prognostic factors for COVID‐19 infection and its relationship with human leukocyte antigen (HLA) in kidney transplant recipients. Material and method Three hundred fifty kidney transplant recipients were included in the study. Recipients were divided into two groups: COVID‐19(+) (n = 100) and control (n = 250). The relationships between HLA frequencies, COVID‐19 infection, and prognostic factors (age, donor type, immunosuppression protocol, etc.) were then evaluated. Logistic regression analysis, heatmap, and decision tree methods were used to determine predictive and prognostic factors. The study was performed retrospectively. Results Advanced age and deceased transplantation emerged as predictive of SARS‐CoV‐2 infection, while the presence of HLA‐A*11, the HLA match ratio, and high‐dose tacrolimus were identified as prognostic factors in kidney transplant recipients. HLA‐A10, HLA‐B*13, HLA‐B22, and HLA‐B*55 were shown to be associated with SARS‐CoV‐2 infection at univariate analysis, and HLA‐B*57, HLA‐DRB1*11, and HLA‐DRB1*13 at logistic regression analysis. Conclusion HLA‐A10, HLA‐B*13, HLA‐B*55, HLA‐B*57, HLA‐DRB1*11, and HLA‐DRB1*13 were identified for the first time in the literature associated with SARS‐CoV‐2 infection in kidney transplant recipients.

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Background and Aims Donor-specific antibody (DSA) development is mainly responsible for chronic antibody-mediated rejection. The immunological events that cause the development of DSA is not fully elucidated. The relationship between the Follicular Cytotoxic T cell subgroup and the development of DSA is unknown. In this study we aimed to examine CD8+CXCR5+PD-1+ follicular cytotoxic T cell levels and expression levels of PD1/PD-L1 genes in peripheral blood lymphocytes in recipients who de-novo DSA positive or negative after kidney transplantation (KTX). Method In this study, the expression levels of PD-1, PD-L1 genes were determined using the Real-Time Quantitative PCR method from peripheral blood samples of 22 KTX patients with de-novo DSA positive, 20 KTX patients with DSA negative and 21 healthy control (Table 1). Our patient groups were PRA negative before transplantation. Expression (%) levels of target cells were evaluated by flow cytometry method. IBM SPSS Statistics for Windows Version 22 and R.3.3.2 software were used to evaluate the data. Results PD-1 expression level was higher in the KTX patients with de-novo DSA positive compared to the KTX patients with DSA negative group (p:0.006 CT: 0,84±0,23). According to the results of flow cytometry, CD8+CXCR5+PD-1+ cell expression (%) levels were found to be significantly higher in patients (3,06±1,98) compared to the transplant control group (0,52±0,40) (p: 0.001) (Figure 1). Conclusion It shows that there may be a direct correlation between DSA and PD-1 / PDL-1 mRNA level and CXCR5+PD1+CD8+ follicular cytotoxic T cell in transplant patients after kidney transplantation.

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