PMID- 22310631
OWN - NLM
STAT- MEDLINE
DCOM- 20120524
LR  - 20120207
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 44
IP  - 1
DP  - 2012 Jan
TI  - Analysis of transplant outcomes after five or six human leukocyte 
      antigen-mismatched living donor kidney transplantation.
PG  - 273-5
LID - 10.1016/j.transproceed.2011.11.058 [doi]
AB  - BACKGROUND: Recently, the impact of human leukocyte antigen (HLA) mismatch (MM) 
      on graft outcome has diminished since the introduction of potent 
      immunosuppressive agents, whereas previous reports support the notion that 
      greater numbers of HLA matches are beneficial. This study was undertaken to 
      evaluate outcomes after five or six HLA-mismatched living donor kidney 
      transplantations (LDKT). METHODS: The authors retrospectively reviewed graft 
      function after 2687 LDKTs performed between June 1984 and February 2010. A 
      database of 1364 living related and 1063 living-unrelated donor (LURD) kidney 
      transplantations was used for this study. LURD kidney transplantations were 
      classified into three groups; (1) zero to one HLA MM (n = 158); (2) two to four 
      HLA MM (n = 851); and (3) five to six MM (n = 54). An acute rejection episode was 
      diagnosed based on clinical deterioration of graft function or biopsy findings. 
      Graft survival was calculated using the Kaplan-Meier method. RESULTS: Graft 
      survivals in the zero to one HLA MM, two to four HLA MM, five to six HLA MM, and 
      one-haplo MM LDKT were not significantly different. The rates of acute rejection 
      episodes within 1 year after transplantation were similar irrespective of the HLA 
      MM; (1) zero to one HLA MM (37.3%), (2) two to four HLA MM (35.3%), (3) five to 
      six HLA MM (33.3%; P = .832). CONCLUSIONS: Survival of five or six HLA-mismatched 
      LDKTs was comparable to that of one-haplo MM and relatively well-matched LDKT. 
      The study showed that the presence of five or six HLA MM was not a risk factor 
      for graft survival after LDKT.
CI  - Copyright (c) 2012 Elsevier Inc. All rights reserved.
FAU - Lee, H S
AU  - Lee HS
AD  - Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea.
FAU - Kim, M S
AU  - Kim MS
FAU - Kim, Y S
AU  - Kim YS
FAU - Joo, D J
AU  - Joo DJ
FAU - Ju, M K
AU  - Ju MK
FAU - Kim, S J
AU  - Kim SJ
FAU - Kim, S I
AU  - Kim SI
FAU - Huh, K H
AU  - Huh KH
FAU - Park, K
AU  - Park K
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
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  - Analysis of Variance
MH  - Biopsy
MH  - Chi-Square Distribution
MH  - Female
MH  - Graft Rejection/immunology/prevention & control
MH  - Graft Survival/drug effects
MH  - HLA Antigens/*immunology
MH  - *Histocompatibility
MH  - Histocompatibility Testing
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Isoantibodies/*blood
MH  - Kaplan-Meier Estimate
MH  - Kidney Transplantation/*immunology
MH  - Living Donors/*supply & distribution
MH  - Male
MH  - Middle Aged
MH  - Republic of Korea
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
MH  - Unrelated Donors/*supply & distribution
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)01655-1 [pii]
AID - 10.1016/j.transproceed.2011.11.058 [doi]
PST - ppublish
SO  - Transplant Proc. 2012 Jan;44(1):273-5. doi: 10.1016/j.transproceed.2011.11.058.