PMID- 22672477
OWN - NLM
STAT- MEDLINE
DCOM- 20130110
LR  - 20220408
IS  - 1399-0012 (Electronic)
IS  - 0902-0063 (Linking)
VI  - 26
IP  - 4
DP  - 2012 Jul-Aug
TI  - Human leukocyte antigen mismatches associated with increased risk of rejection, 
      graft failure, and death independent of initial immunosuppression in renal 
      transplant recipients.
PG  - E428-37
LID - 10.1111/j.1399-0012.2012.01654.x [doi]
AB  - Human leukocyte antigen (HLA) mismatches have been shown to adversely affect 
      renal allograft outcomes and remain an important component of the allocation of 
      deceased donor (DD) kidneys. The ongoing importance of HLA mismatches on 
      transplant outcomes in the era of more potent immunosuppression remains 
      debatable. Using Australia and New Zealand Dialysis and Transplant Registry, live 
      and DD renal transplant recipients between 1998 and 2009 were examined. The 
      association between the number of HLA mismatches and HLA-loci mismatches and 
      outcomes were examined. Of the 8036 renal transplant recipients, 59% had between 
      2 and 4 HLA mismatches. Compared with 0 HLA mismatch, increasing HLA mismatches 
      were associated with a higher risk of graft failure and patient death in the 
      adjusted models. HLA mismatches were associated with an incremental risk of 
      rejection although the relative risk was higher for live donor kidney 
      transplants. Increasing HLA-AB and HLA-DR mismatches were associated with a 
      greater risk of acute rejection, graft failure, death-censored graft failure, 
      and/or death. There was no consistent association between initial 
      immunosuppressive regimen and outcomes. Our results corroborate and extend the 
      previous registry analyses demonstrating that HLA mismatches are associated with 
      poorer transplant outcomes independent of immunosuppression and transplant era.
CI  - (c) 2012 John Wiley & Sons A/S.
FAU - Lim, Wai H
AU  - Lim WH
AD  - Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, WA, 
      Australia. wai.lim@health.wa.gov.au
FAU - Chadban, Steve J
AU  - Chadban SJ
FAU - Clayton, Philip
AU  - Clayton P
FAU - Budgeon, Charley A
AU  - Budgeon CA
FAU - Murray, Kevin
AU  - Murray K
FAU - Campbell, Scott B
AU  - Campbell SB
FAU - Cohney, Solomon
AU  - Cohney S
FAU - Russ, Graeme R
AU  - Russ GR
FAU - McDonald, Stephen P
AU  - McDonald SP
LA  - eng
PT  - Journal Article
DEP - 20120604
PL  - Denmark
TA  - Clin Transplant
JT  - Clinical transplantation
JID - 8710240
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adult
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Rejection/*etiology/*mortality
MH  - Graft Survival/immunology
MH  - HLA Antigens/*immunology
MH  - Histocompatibility Testing
MH  - Humans
MH  - Immunosuppression Therapy/*mortality
MH  - Kidney Transplantation/*immunology/*mortality
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Prospective Studies
MH  - Risk Factors
MH  - Survival Rate
MH  - Young Adult
EDAT- 2012/06/08 06:00
MHDA- 2013/01/11 06:00
CRDT- 2012/06/08 06:00
PHST- 2012/03/23 00:00 [accepted]
PHST- 2012/06/08 06:00 [entrez]
PHST- 2012/06/08 06:00 [pubmed]
PHST- 2013/01/11 06:00 [medline]
AID - 10.1111/j.1399-0012.2012.01654.x [doi]
PST - ppublish
SO  - Clin Transplant. 2012 Jul-Aug;26(4):E428-37. doi: 
      10.1111/j.1399-0012.2012.01654.x. Epub 2012 Jun 4.