PMID- 22310626
OWN - NLM
STAT- MEDLINE
DCOM- 20120524
LR  - 20120207
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 44
IP  - 1
DP  - 2012 Jan
TI  - The effect of donor-recipient relationship on long-term outcomes of living 
      related donor renal transplantation.
PG  - 257-60
LID - 10.1016/j.transproceed.2011.11.017 [doi]
AB  - BACKGROUND: Presensitization to human leukocyte antigen (HLA) tends to decrease 
      renal graft survival. During the pregnancy, fetal blood is frequently exposed to 
      the maternal circulation possibly inducing maternal immunization to paternal HLA 
      inherited by the fetus. In this way, pregnancy may occasionally present a hazard 
      to renal graft survival. In this study, we compared retrospectively graft 
      survivals according to living related donor-recipient pairs. MATERIALS AND 
      METHODS: From July 1979 to January 2011, 374 patients underwent living related 
      renal transplantation sharing at least one HLA haplotype with their donor. We 
      compared acute rejection and complication rates as well as long-term graft 
      survival according to the donor-recipient paring: child-to-mother, 
      child-to-father, mother-to-child, father-to-child, and one haplotype-matched 
      siblings. All patients received immunosuppressive therapy, consisting of a 
      calcineurin inhibitor, mycophenolate mofetil, or azathioprine and prednisolone. 
      RESULTS: Twenty-one cases (5.6%) were child-to-father paring; 28 (7.5%), 
      child-to-mother; 179 (47.9%), one-haplotype-matched siblings; 46 (12.3%), 
      father-to-child; and 100 (26.7%), mother-to-child paring. Child-to-father pairing 
      displayed the best graft survival; child-to-mother (hazard ratio [HR] = 1.709, P 
      = .662) and one-haplotype-matched siblings (HR = 6.589, P = .062) showed no 
      significant difference. Father-to-child pares experienced poorer outcomes than 
      child-to-father pairs (HR = 11.579, P = .017) and mother-to-child, the poorest 
      graft survival (HR 17.188, P = .005). CONCLUSION: Pregnancy continues to be a 
      significant source of presensitization in the course of gestation and after 
      parturition. Graft failure can result from an anamnestic reaction subsequent to 
      intrauterine exposure of the mother to HLA of a fetus due to sensitization.
CI  - Copyright (c) 2012 Elsevier Inc. All rights reserved.
FAU - Choi, J Y
AU  - Choi JY
AD  - Transplantation Center, Hanyang University Hospital, Seoul, Korea.
FAU - Kwon, O J
AU  - Kwon OJ
FAU - Kang, C M
AU  - Kang CM
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (HLA Antigens)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Adult
MH  - Chi-Square Distribution
MH  - Drug Therapy, Combination
MH  - *Family
MH  - Female
MH  - Graft Rejection/immunology/prevention & control
MH  - Graft Survival
MH  - HLA Antigens/genetics/*immunology
MH  - Haplotypes
MH  - *Histocompatibility
MH  - Histocompatibility Testing
MH  - Histocompatibility, Maternal-Fetal
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Isoantibodies/*blood
MH  - Kaplan-Meier Estimate
MH  - *Kidney Transplantation/immunology
MH  - *Living Donors
MH  - Male
MH  - Middle Aged
MH  - Pregnancy
MH  - Proportional Hazards Models
MH  - Republic of Korea
MH  - Retrospective Studies
MH  - Time Factors
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2012/02/09 06:00
MHDA- 2012/05/25 06:00
CRDT- 2012/02/08 06:00
PHST- 2012/02/08 06:00 [entrez]
PHST- 2012/02/09 06:00 [pubmed]
PHST- 2012/05/25 06:00 [medline]
AID - S0041-1345(11)01613-7 [pii]
AID - 10.1016/j.transproceed.2011.11.017 [doi]
PST - ppublish
SO  - Transplant Proc. 2012 Jan;44(1):257-60. doi: 10.1016/j.transproceed.2011.11.017.