PMID- 21452411
OWN - NLM
STAT- MEDLINE
DCOM- 20110502
LR  - 20190713
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 91
IP  - 1
DP  - 2011 Jan 15
TI  - Association of mismatches for HLA-DR with incidence of posttransplant hip 
      fracture in kidney transplant recipients.
PG  - 65-9
AB  - BACKGROUND: Bone fractures are a frequent complication after kidney 
      transplantation, for which various predisposing factors have been identified. It 
      has been suggested that human leukocyte antigen (HLA) mismatch increases the 
      risk. METHODS: Data on hip fractures occurring in the first 5 years 
      posttransplant were analyzed among kidney transplants from deceased donors 
      performed between 1995 and 2008 and reported to the Collaborative Transplant 
      Study. RESULTS: In the 20,509 patients analyzed, the cumulative rate of hip 
      fracture by year 5 posttransplant was 0.85%. Cox regression analysis identified 
      the following risk factors: female recipients aged 40 to 59 years (hazard ratio 
      [HR] 2.26, P=0.029), female recipients 60 years or older (HR 5.14, P<0.001), male 
      recipients 60 years or older (HR 2.39, P=0.028), and donor age more than or equal 
      to 60 years (HR 1.75, P=0.009). Using the rate of fractures in recipients with 
      zero HLA-DR mismatch as the reference, the risk of hip fracture increased for 
      grafts with one HLA-DR mismatch to HR 1.85 (95% confidence interval [CI] 
      1.18-2.89, P=0.007) and with two HLA-DR mismatches to HR 2.24 (CI 1.25-4.02, 
      P=0.007). There was a significant association between the number of HLA-DR 
      mismatches and the diagnosis of osteoporosis 5 years after transplantation: one 
      HLA-DR mismatch risk ratio 1.26 (CI 1.12-1.43, P<0.001) and two HLA-DR mismatches 
      risk ratio 1.45 (CI 1.20-1.74, P<0.001). CONCLUSION: The risk of hip fracture 
      after kidney transplantation seems to be markedly exacerbated by HLA-DR 
      mismatching. These findings add to the growing base of evidence that HLA-DR 
      matching influences morbidity after kidney transplantation.
FAU - Opelz, Gerhard
AU  - Opelz G
AD  - Department of Transplantation Immunology, University of Heidelberg, Heidelberg, 
      Germany.
FAU - Dohler, Bernd
AU  - Dohler B
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (HLA-DR Antigens)
RN  - 0 (Immunosuppressive Agents)
RN  - 83HN0GTJ6D (Cyclosporine)
RN  - HU9DX48N0T (Mycophenolic Acid)
RN  - MRK240IY2L (Azathioprine)
RN  - WM0HAQ4WNM (Tacrolimus)
SB  - IM
MH  - Adrenal Cortex Hormones/adverse effects/therapeutic use
MH  - Adult
MH  - Azathioprine/adverse effects/therapeutic use
MH  - Cyclosporine/adverse effects/therapeutic use
MH  - Diabetic Nephropathies/immunology
MH  - Female
MH  - Graft Rejection/immunology
MH  - HLA-DR Antigens/*immunology
MH  - Hip Fractures/*immunology
MH  - Histocompatibility Testing
MH  - Humans
MH  - Immunosuppressive Agents/adverse effects/therapeutic use
MH  - Kidney Transplantation/*adverse effects/immunology
MH  - Male
MH  - Middle Aged
MH  - Mycophenolic Acid/adverse effects/therapeutic use
MH  - Postoperative Complications/drug therapy/immunology
MH  - Retrospective Studies
MH  - Tacrolimus/adverse effects/therapeutic use
MH  - Treatment Outcome
EDAT- 2011/04/01 06:00
MHDA- 2011/05/03 06:00
CRDT- 2011/04/01 06:00
PHST- 2011/04/01 06:00 [entrez]
PHST- 2011/04/01 06:00 [pubmed]
PHST- 2011/05/03 06:00 [medline]
AID - 10.1097/tp.0b013e3181fa94d6 [doi]
PST - ppublish
SO  - Transplantation. 2011 Jan 15;91(1):65-9. doi: 10.1097/tp.0b013e3181fa94d6.