PMID- 17006322
OWN - NLM
STAT- MEDLINE
DCOM- 20061108
LR  - 20061115
IS  - 0041-1337 (Print)
IS  - 0041-1337 (Linking)
VI  - 82
IP  - 6
DP  - 2006 Sep 27
TI  - Recurrence of IgA nephropathy among renal allograft recipients from living donors 
      is greater among those with zero HLA mismatches.
PG  - 759-62
AB  - BACKGROUND: Risk factors contributing to recurrence of IgA nephropathy (IgAN) 
      after transplantation are unclear. Some (but not all) series have suggested 
      greater degrees of human leukocyte antigen (HLA) matching play a role. METHODS: 
      Using registry data including all kidney transplants performed in Australia and 
      New Zealand between 1987 and 2004 we examined IgAN recurrence among living donors 
      with zero HLA-mismatches. RESULTS: Of 1354 grafts performed in recipients with 
      IgAN, live donors (LDs) accounted for 488 including 108 with zero HLA-mismatches. 
      Biopsy-proven IgAN recurrence was reported for 110 (7%) of grafts overall, but 
      17% of those who received zero HLA-mismatched LD grafts (HR for recurrence free 
      graft survival 2.7 [95% CI 1.5-5.1], P=0.001). There was no significant 
      difference in recurrence rates between zero and >or=1 HLA-mismatched grafts from 
      cadaveric donors (CDs). Recurrence of IgAN was associated with worse graft 
      survival, more so among LD recipients (HR 8.5 [4.8-15.2], P<0.001) than CD 
      recipients (HR 4.5 [2.6-7.5], P<0.001). However, there was no difference in graft 
      survival between zero and >or=1 HLA mismatched LD recipients whose native disease 
      was IgAN. In contrast, zero HLA mismatched recipients of kidneys with other 
      primary renal disease enjoyed a graft survival advantage. No difference in 
      recurrence rates was seen among those with HLA B12, B35 or DR4. CONCLUSIONS: The 
      increased rates of IgAN-related graft loss among zero HLA-mismatched LD 
      recipients counterbalance the advantage normally seen among zero HLA-mismatched 
      recipients. However, since graft survivals are similar, there is no reason to 
      avoid donor-recipient pairs with zero HLA-mismatches in this setting.
FAU - McDonald, Stephen P
AU  - McDonald SP
AD  - ANZDATA Registry, Adelaide, Australia. stephenm@anzdata.org.au
FAU - Russ, Graeme R
AU  - Russ GR
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
SB  - IM
MH  - Australia/epidemiology
MH  - Female
MH  - Glomerulonephritis, IGA/*epidemiology/immunology
MH  - Graft Survival
MH  - *Histocompatibility Testing
MH  - Humans
MH  - Kidney Transplantation/*immunology
MH  - Male
MH  - New Zealand/epidemiology
MH  - Predictive Value of Tests
MH  - Recurrence
MH  - Retrospective Studies
MH  - Transplantation, Homologous
MH  - Treatment Outcome
EDAT- 2006/09/29 09:00
MHDA- 2006/11/10 09:00
CRDT- 2006/09/29 09:00
PHST- 2006/09/29 09:00 [pubmed]
PHST- 2006/11/10 09:00 [medline]
PHST- 2006/09/29 09:00 [entrez]
AID - 00007890-200609270-00008 [pii]
AID - 10.1097/01.tp.0000230131.66971.45 [doi]
PST - ppublish
SO  - Transplantation. 2006 Sep 27;82(6):759-62. doi: 
      10.1097/01.tp.0000230131.66971.45.