PMID- 24202143
OWN - NLM
STAT- MEDLINE
DCOM- 20140402
LR  - 20141120
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 97
IP  - 3
DP  - 2014 Feb 15
TI  - Transplantation results of completely HLA-mismatched living and completely 
      HLA-matched deceased-donor kidneys are comparable.
PG  - 330-6
LID - 10.1097/01.TP.0000435703.61642.43 [doi]
AB  - BACKGROUND: Human leukocyte antigen (HLA) mismatches are known to influence graft 
      survival in deceased-donor kidney transplantation. We studied the effect of HLA 
      mismatches in a population of recipients of deceased-donor or living-donor kidney 
      transplantations. METHODS: All 1998 transplantations performed in our center 
      between 1990 and 2011 were included in this retrospective cohort study. Four 
      different multivariable Cox proportional hazard analyses were performed with HLA 
      mismatches as continuous variable, as categorical variable (total number of HLA 
      mismatches), as binary variable (zero vs. nonzero HLA mismatches), and HLA-A, -B, 
      and -DR mismatches included separately. RESULTS: Nine hundred ninety-one patients 
      received a deceased-donor kidney and 1007 received a living-donor kidney. In 
      multivariable Cox analysis, HLA mismatches, recipient age, current panel-reactive 
      antibodies, transplant year, donor age, calcineurin inhibitor treatment, and 
      donor type were found to have a significant and independent influence on the risk 
      of graft failure, censored for death. Variables representing the total number of 
      HLA-A, -B, and -DR mismatches had a significant and comparable influence in all 
      analyses. CONCLUSIONS: The influence of HLA mismatches on death-censored graft 
      survival holds true for both deceased- and living-donor kidney transplantation. 
      However, the relative risk of death-censored graft failure of a 2-2-2 mismatched 
      living-donor kidney is comparable with that of a 0-0-0 mismatched deceased-donor 
      kidney.
FAU - Laging, Mirjam
AU  - Laging M
AD  - 1 Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The 
      Netherlands. 2 Department of Immunohematology and Blood Transfusion, Leiden 
      University Medical Center, Leiden, The Netherlands. 3 Department of General 
      Surgery, Erasmus Medical Center, Rotterdam, The Netherlands. 4 Address 
      correspondence to: Mirjam Laging, M.Sc., Department of Internal Medicine, Erasmus 
      Medical Center, Room D408, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
FAU - Kal-van Gestel, Judith A
AU  - Kal-van Gestel JA
FAU - Haasnoot, Geert W
AU  - Haasnoot GW
FAU - Claas, Frans H J
AU  - Claas FH
FAU - van de Wetering, Jacqueline
AU  - van de Wetering J
FAU - Ijzermans, Jan N M
AU  - Ijzermans JN
FAU - Weimar, Willem
AU  - Weimar W
FAU - Roodnat, Joke I
AU  - Roodnat JI
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (Calcineurin Inhibitors)
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adult
MH  - Algorithms
MH  - Calcineurin Inhibitors
MH  - Cohort Studies
MH  - Female
MH  - Graft Rejection/immunology
MH  - Graft Survival
MH  - HLA Antigens/*chemistry
MH  - Histocompatibility/*immunology
MH  - Histocompatibility Testing/methods
MH  - Humans
MH  - Kidney/immunology
MH  - Kidney Transplantation/*methods
MH  - Living Donors
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Organ Transplantation/*methods
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Risk
MH  - Tissue Donors
MH  - Tissue and Organ Procurement
MH  - Treatment Outcome
EDAT- 2013/11/10 06:00
MHDA- 2014/04/03 06:00
CRDT- 2013/11/09 06:00
PHST- 2013/11/09 06:00 [entrez]
PHST- 2013/11/10 06:00 [pubmed]
PHST- 2014/04/03 06:00 [medline]
AID - 10.1097/01.TP.0000435703.61642.43 [doi]
PST - ppublish
SO  - Transplantation. 2014 Feb 15;97(3):330-6. doi: 10.1097/01.TP.0000435703.61642.43.