PMID- 18497690
OWN - NLM
STAT- MEDLINE
DCOM- 20080806
LR  - 20080523
IS  - 0041-1337 (Print)
IS  - 0041-1337 (Linking)
VI  - 85
IP  - 10
DP  - 2008 May 27
TI  - The role of donor-recipient relationship in long-term outcomes of living donor 
      renal transplantation.
PG  - 1483-8
LID - 10.1097/TP.0b013e3181705a0f [doi]
AB  - BACKGROUND: Graft failure related to acute and chronic rejection remains an 
      important problem in transplantation. An association has been reported between 
      microchimerism and the development of tolerance. Since it has been established 
      that cells of fetal origin can be found in maternal tissues long after 
      parturition, and cells of maternal origin may persist for years in offspring, we 
      hypothesized that this fetal-maternal microchimerism may confer tolerance and 
      thus less graft loss for kidneys transplanted between mothers and their 
      offspring. METHODS: We used data from the Scientific Registry of Transplant 
      Recipients to compare death-censored graft survival among recipients of 
      living-related renal transplants sharing at least one human leukocyte antigen 
      (HLA) haplotype with their donor. A total of 23,064 such transplants were 
      reported from 1995 to 2004. A Cox proportional hazards model was constructed to 
      compare death-censored graft survival among the following donor-recipient 
      pairings: child-to-mother, child-to-father, mother-to-child, father-to-child, 
      1-haplotype matched siblings, and HLA-identical siblings. RESULTS: HLA-identical 
      sibling recipients had the best survival, but results for the child-to-father 
      group were not significantly worse (hazard ratio=1.07, P=0.47). Mother-to-child 
      transplants had the poorest graft survival (hazard ratio=2.61, P<0.0001). We 
      found no evidence of tolerance to kidneys transplanted between mothers and 
      offspring. CONCLUSIONS: Our analysis of 1-haplotype matched living-related renal 
      transplants argues against tolerance to organs based on fetal-maternal 
      microchimerism. Mechanistic studies examining the relationship between chimerism 
      and immune sensitization would be useful to explore our results, and may 
      contribute to a better understanding of tolerance.
FAU - Miles, Clifford D
AU  - Miles CD
AD  - Department of Medicine, Nebraska Medical Center, Omaha, NE, USA.
FAU - Schaubel, Douglas E
AU  - Schaubel DE
FAU - Liu, Dandan
AU  - Liu D
FAU - Port, Friedrich K
AU  - Port FK
FAU - Rao, Panduranga S
AU  - Rao PS
LA  - eng
GR  - 234-2005-37009C/PHS HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Child
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Kidney Transplantation/mortality/*psychology
MH  - *Living Donors
MH  - Male
MH  - Middle Aged
MH  - *Nuclear Family
MH  - Parent-Child Relations
MH  - Research Design
MH  - Retrospective Studies
MH  - Siblings
MH  - Survival Analysis
MH  - Time Factors
EDAT- 2008/05/24 09:00
MHDA- 2008/08/07 09:00
CRDT- 2008/05/24 09:00
PHST- 2008/05/24 09:00 [pubmed]
PHST- 2008/08/07 09:00 [medline]
PHST- 2008/05/24 09:00 [entrez]
AID - 00007890-200805270-00020 [pii]
AID - 10.1097/TP.0b013e3181705a0f [doi]
PST - ppublish
SO  - Transplantation. 2008 May 27;85(10):1483-8. doi: 10.1097/TP.0b013e3181705a0f.