PMID- 20682021
OWN - NLM
STAT- MEDLINE
DCOM- 20110331
LR  - 20120314
IS  - 1399-0012 (Electronic)
IS  - 0902-0063 (Linking)
VI  - 24
IP  - 6
DP  - 2010 Nov-Dec
TI  - The effect of HLA mismatch on highly sensitized renal allograft recipients.
PG  - E247-52
LID - 10.1111/j.1399-0012.2010.01306.x [doi]
AB  - INTRODUCTION: We examined the effects of increasing human leukocyte antigen (HLA) 
      mismatches (MM) on long-term graft outcomes in patients transplanted with a panel 
      reactive antibody (PRA) >80% over a 10-yr period. METHODS: A total of 142 
      recipients were divided into three groups based on the number of HLA MM with 
      their allograft (0-2, 3-4 and 5-6 MM; Groups I, II and III). All patients 
      received the same immunosuppression protocol. RESULTS: The higher MM groups had a 
      higher incidence of rejection (4.4% vs. 11.4% vs. 31.3%, p < 0.01). A 
      multivariate analysis showed that rejection was the only significant variable 
      affecting graft loss (OR = 7.45, p = 0.01). There was a trend toward more CMV 
      infection and worse graft function with higher MM. Kaplan-Meier five-yr graft 
      survival estimates were 100% vs. 81% vs. 74% for Groups I, II and III, 
      respectively (p = 0.14). CONCLUSIONS: In patients with PRA levels >80%, a higher 
      HLA MM is associated with higher incidence of acute rejection. Acute rejection 
      was the only significant variable affecting graft loss. We found a trend toward 
      more CMV infections and worse graft outcomes with higher MM. Closer HLA matching 
      and immunologic monitoring needs to be considered to improve graft outcomes among 
      sensitized recipients.
CI  - (c) 2010 John Wiley & Sons A/S.
FAU - Paramesh, Anil S
AU  - Paramesh AS
AD  - Tulane Abdominal Transplant Institute, Tulane University School of Medicine, New 
      Orleans, LA, USA. aparames@tulane.edu
FAU - Zhang, Rubin
AU  - Zhang R
FAU - Baber, John
AU  - Baber J
FAU - Yau, C L
AU  - Yau CL
FAU - Slakey, Douglas P
AU  - Slakey DP
FAU - Killackey, Mary T
AU  - Killackey MT
FAU - Ren, Qing
AU  - Ren Q
FAU - Sullivan, Karen
AU  - Sullivan K
FAU - Heneghan, Jean
AU  - Heneghan J
FAU - Florman, Sander S
AU  - Florman SS
LA  - eng
PT  - Journal Article
PL  - Denmark
TA  - Clin Transplant
JT  - Clinical transplantation
JID - 8710240
RN  - 0 (HLA Antigens)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Adult
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Rejection/*immunology
MH  - Graft Survival
MH  - HLA Antigens/*immunology
MH  - Histocompatibility Testing
MH  - Humans
MH  - Isoantibodies/*blood
MH  - Kidney Transplantation/*immunology
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Rate
MH  - Transplantation, Homologous/*immunology
EDAT- 2010/08/05 06:00
MHDA- 2011/04/01 06:00
CRDT- 2010/08/05 06:00
PHST- 2010/08/05 06:00 [entrez]
PHST- 2010/08/05 06:00 [pubmed]
PHST- 2011/04/01 06:00 [medline]
AID - CTR1306 [pii]
AID - 10.1111/j.1399-0012.2010.01306.x [doi]
PST - ppublish
SO  - Clin Transplant. 2010 Nov-Dec;24(6):E247-52. doi: 
      10.1111/j.1399-0012.2010.01306.x.