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Alfraih F, Alawwami M, Aljurf M, Alhumaidan H, Alsaedi H, El Fakih R, Alotaibi B, Rasheed W, Bernas SN, Massalski C, Heidl A, Sauter J, Lange V, Schmidt AH. High-resolution HLA allele and haplotype frequencies of the Saudi Arabian population based on 45,457 individuals and corresponding stem cell donor matching probabilities. Hum Immunol 2020; 82:97-102. [PMID: 33388178 DOI: 10.1016/j.humimm.2020.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 11/20/2022]
Abstract
We estimated HLA allele and haplotype frequencies of the Saudi Arabian population from a sample of 45,457 registered stem cell donors. The most frequent HLA alleles were A*02:01g (18.5%), C*06:02g (16.1%), B*51:01g (14.1%), DRB1*07:01g (16.2%), DQB1*02:01g (30.5%), and DPB1*04:01g (33.6%). The most frequent 5-locus haplotypes were A*02:05g~C*06:02g~B*50:01g~DRB1*07:01g~DQB1*02:01g (1.73%), A*02:01g~C*06:02g~B*50:01g~DRB1*07:01g~DQB1*02:01g (1.66%), and A*26:01g~C*07:02g~B*08:01g~DRB1*03:01g~DQB1*02:01g (1.38%). Furthermore, we used the calculated haplotype frequencies to estimate stem cell donor matching probabilities for Saudi Arabian donor and patient populations under various matching requirements. These results are relevant for strategic donor registry planning in the Kingdom of Saudi Arabia.
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Affiliation(s)
- Feras Alfraih
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Moheeb Alawwami
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mahmoud Aljurf
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hind Alhumaidan
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hawazen Alsaedi
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Riad El Fakih
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Bander Alotaibi
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Walid Rasheed
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Shaheen M, Almohareb F, Aljohani N, Ayas M, Chaudhri N, Abosoudah I, Alotaibi S, Alshahrani M, Alsharif F, Akhtar S, Alhumaidan H, Rasheed W, Alfraih F, Al-Anazi K, Alhashmi H, Al-Daama S, Hanbali A, Alsaleh K, Alzahrani H, Ibrahim K, Alawwami M, Albeirouti B, Albeihany A, Alabdulwahab A, Motabi I, Zaidi SZA, Ahmed SO, Aljefri A, Hussain F, Alahmari A, Hashmi S, Elsolh H, Alseraihy A, Aljurf M. Hematopoietic stem cell transplantation in Saudi Arabia between 1984 and 2016: Experience from four leading tertiary care hematopoietic stem cell transplantation centers. Hematol Oncol Stem Cell Ther 2020; 14:169-178. [PMID: 32888899 DOI: 10.1016/j.hemonc.2020.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 07/26/2020] [Indexed: 11/25/2022] Open
Abstract
Saudi Arabia is the largest of the Arabian Gulf countries with a total population of 33.41 million as of 2017. This report summarizes the experience from four leading tertiary care hematopoietic stem cell transplantation (HSCT) centers in Saudi Arabia representing more than 90% of all HSCTs performed in the country. Between 1984 and 2016, a total of 6,184 HSCTs were performed. Of these, 3,586 HSCTs were performed in adults and 2,598 HSCTs were performed in pediatric patients. Malignancy was the main indication for transplantation (47%). While most transplants were performed from an identical sibling donor, HSCTs from cord blood, unrelated and, more recently, haploidentical donors have also been performed. Relative shortage of HSCT bed capacity is perceived to be a limiting factor in Saudi Arabia. Lately, more HSCT centers are emerging with rapid growth, which may significantly improve the access to HSCT in the country in the near future.
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Affiliation(s)
- Marwan Shaheen
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia.
| | - Fahad Almohareb
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia
| | - Naif Aljohani
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Jeddah, Saudi Arabia
| | - Mouhab Ayas
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia
| | - Naeem Chaudhri
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia
| | - Ibraheem Abosoudah
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Jeddah, Saudi Arabia
| | | | | | - Fahad Alsharif
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia
| | - Saad Akhtar
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia
| | - Hind Alhumaidan
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia
| | - Walid Rasheed
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia
| | - Feras Alfraih
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia
| | | | - Hani Alhashmi
- King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Saad Al-Daama
- King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Amr Hanbali
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia
| | - Khalid Alsaleh
- King Khalid University Hospital, Riyadh, Saudi Arabia; Department of Medicine, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Hazzaa Alzahrani
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia
| | - Khalid Ibrahim
- Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Moheeb Alawwami
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia
| | - Bassim Albeirouti
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Jeddah, Saudi Arabia
| | | | | | | | | | - Syed O Ahmed
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia
| | - Abdullah Aljefri
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia
| | - Fazal Hussain
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia
| | - Ali Alahmari
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia
| | - Shahrukh Hashmi
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia
| | - Hassan Elsolh
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia
| | - Amal Alseraihy
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia
| | - Mahmoud Aljurf
- King Faisal Specialist Hospital and Research Centre, Hematopoietic Stem Cell Transplantation, Riyadh, Saudi Arabia
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Abstract
BACKGROUND HLA-DQ donor-specific antibodies (DSA) are implicated in allograft dysfunction after renal and lung transplantation. Limited data exists on the impact of HLA-DQ antibodies on heart transplant patients. OBJECTIVE To investigate the impact of DSA formation on allograft function and outcomes in heart transplant patients. DESIGN Retrospective cohort study. SETTING Collating post-transplantation patient data from computerized database in a tertiary hospital in Riyadh, Saudi Arabia from January 2006 to October 2014. PATIENTS AND METHODS We excluded recipients with positive preoperative complement-dependent-cytotoxicity crossmatch grafts and those with preformed DSA. Anti-HLA antibodies were identified using Luminex-based assay in sera collected before transplantation with a routine endomyocardial biopsy the first year and then annually. MAIN OUTCOME MEASURES Primary outcome measures were all-cause mortality, development of antibody mediated rejection, treated acute cellular rejection (ACR) and cardiac allograft vasculopathy (CAV). SAMPLE SIZE 127 patients. RESULTS DSA formation occurred in 43/127 (34%), with 33/43 (77%) targeting HLA-DQ antigens alone (n=7) or in combination with -DR, -A or B antibodies (n=26). Most (76%) were male and the mean (SD) age was 36 (14) years. Ten patients developed -A, -B or -DR antibodies without -DQ antibodies also present. Treated ACR (P=.011), reduced left ventricular ejection fraction (P less than .001), CAV development (P=.003), and all-cause mortality (P=.01) were all significantly more prevalent in the DSA-positive cohort. CONCLUSION HLA-DQ donor-specific antibodies were the most common type detected and may play a significant role in poor outcomes post-cardiac transplantation. This emphasizes the importance of HLA-DQ matching and monitoring for DSA formation in order to minimize post-transplantation immunological risk. LIMITATIONS Retrospective design comes with inherent biases, results from single institute, with a particularly young cohort. CONFLICT OF INTEREST None.
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Affiliation(s)
| | | | | | - Nedim Selimovic
- Nedim Selimovic, Department of Cardiology, Angereds Narsjukhus,, SE-424 Angered, Sweden, , T: +46703579042, ORCID: http://orcid.org/0000-0001.8189-412X
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