Human leukocyte antigen mismatches associated with increased risk of rejection, graft failure, and death independent of initial immunosuppression in renal transplant recipients

Clinical Transplantation
Wai H LimStephen P McDonald

Abstract

Human leukocyte antigen (HLA) mismatches have been shown to adversely affect renal allograft outcomes and remain an important component of the allocation of deceased donor (DD) kidneys. The ongoing importance of HLA mismatches on transplant outcomes in the era of more potent immunosuppression remains debatable. Using Australia and New Zealand Dialysis and Transplant Registry, live and DD renal transplant recipients between 1998 and 2009 were examined. The association between the number of HLA mismatches and HLA-loci mismatches and outcomes were examined. Of the 8036 renal transplant recipients, 59% had between 2 and 4 HLA mismatches. Compared with 0 HLA mismatch, increasing HLA mismatches were associated with a higher risk of graft failure and patient death in the adjusted models. HLA mismatches were associated with an incremental risk of rejection although the relative risk was higher for live donor kidney transplants. Increasing HLA-AB and HLA-DR mismatches were associated with a greater risk of acute rejection, graft failure, death-censored graft failure, and/or death. There was no consistent association between initial immunosuppressive regimen and outcomes. Our results corroborate and extend the previous registry analyses ...Continue Reading

References

Nov 15, 1992·Journal of the American College of Cardiology·A NitenbergJ P Cachera
Apr 11, 1991·The New England Journal of Medicine·D W GjertsonM R Mickey
Sep 22, 1994·The New England Journal of Medicine·P J HeldH Krakauer
Apr 1, 1994·The British Journal of Surgery·I J BeckinghamM L Nicholson
Nov 5, 1999·The New England Journal of Medicine·M A SchnitzlerD C Brennan
Oct 12, 2000·The New England Journal of Medicine·S K TakemotoJ M Cecka
May 1, 2002·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Markus S GillichHans Ulrich Klehr
Feb 6, 2004·The New England Journal of Medicine·John P RobertsFriedrich K Port
Aug 17, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Xuanming SuGlenn M Chertow
Mar 21, 2009·Transplantation·Gerhard OpelzUNKNOWN Collaborative Transplant Study

❮ Previous
Next ❯

Citations

Dec 29, 2015·Transplantation Proceedings·B Chopra, K K Sureshkumar
Dec 3, 2014·Transplant International : Official Journal of the European Society for Organ Transplantation·Michael Jin CaseyKenneth A Andreoni
Apr 2, 2016·Clinical Journal of the American Society of Nephrology : CJASN·Nagaraju Sarabu, Donald E Hricik
Apr 2, 2016·Clinical Journal of the American Society of Nephrology : CJASN·Wai H LimGermaine Wong
Feb 18, 2015·Transplant International : Official Journal of the European Society for Organ Transplantation·Wai H LimGermaine Wong
Apr 22, 2015·Transplantation Proceedings·K-H KimC-D Kim
Jan 28, 2016·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·E N RudolphE B Finger
May 18, 2005·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Cameron G DensemNicholas H Brooks
Nov 12, 2016·Transplantation Reviews·Ben C Reynolds, Kathryn J Tinckam
Oct 28, 2016·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·E DugastS Brouard
Jan 15, 2018·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Ankit Sharma, Anne M Durkan
Apr 25, 2018·Clinical Journal of the American Society of Nephrology : CJASN·Caner Süsal, Martin Zeier
Apr 25, 2018·Clinical Journal of the American Society of Nephrology : CJASN·Napat LeeaphornFrancesca Cardarelli
Jul 25, 2019·Nephrology·William R MulleyRhonda F Holdsworth
Dec 24, 2019·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Susan S WanKate Wyburn
Dec 10, 2019·Current Opinion in Organ Transplantation·Uwe HeemannUNKNOWN Eurotransplant Kidney Advisory Committee
May 11, 2020·Pediatric Transplantation·Andreea Liana RãchişanJustine Bacchetta
Oct 1, 2020·Pediatric Transplantation·Luiza do Nascimento Ghizoni PereiraPaulo Cesar Koch-Nogueira
Dec 19, 2018·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Laura A MichielsenLuuk B Hilbrands
Jan 7, 2020·Transplantation Proceedings·Louisa Sarah QuastPeter Schenker
Apr 15, 2021·Stem Cell Research & Therapy·Belén Álvarez-PalomoSergi Querol

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.