PMID- 24461002
OWN - NLM
STAT- MEDLINE
DCOM- 20140915
LR  - 20181203
IS  - 1399-0039 (Electronic)
IS  - 0001-2815 (Linking)
VI  - 82
IP  - 4
DP  - 2013 Oct
TI  - Ceppellini Lecture 2012: collateral damage from HLA mismatching in kidney 
      transplantation.
PG  - 235-42
LID - 10.1111/tan.12147 [doi]
AB  - Inclusion of human leukocyte antigen (HLA) matching in donor kidney allocation 
      schemes has been based solely on its association with graft survival. Other 
      long-term effects associated with HLA incompatibility are largely unexplored. 
      Data from deceased donor kidney transplants reported to the Collaborative 
      Transplant Study have been analyzed to assess the relation between HLA 
      mismatching and clinical events to 3 years post-transplant, and an overview of 
      these analyses is presented. A significant correlation was observed between the 
      number of mismatches and the need for anti-rejection therapy during the first 
      year post-transplant, which was maintained for HLA-DR and HLA-A + B mismatching 
      separately and at years 2 and 3 post-transplant. The number of HLA-DR mismatches 
      and the number of HLA-A + B mismatches as well as rejection treatment showed 
      significant associations with the dose of maintenance steroids. The cumulative 
      incidences of death with a functioning graft from infection or cardiovascular 
      causes, but not from cancer, were also significantly associated with HLA 
      mismatching. The number of HLA-DR mismatches showed a significant association 
      with the incidence of non-Hodgkin lymphoma and hip fractures. These findings show 
      that the adverse consequences of HLA mismatching on kidney transplants extend 
      beyond an effect on graft survival, and include an increased risk of death with a 
      functioning graft, non-Hodgkin lymphoma and hip fracture.
CI  - (c) 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Opelz, G
AU  - Opelz G
AD  - Department of Transplantation Immunology, University of Heidelberg, Heidelberg, 
      Germany.
FAU - Dohler, B
AU  - Dohler B
LA  - eng
PT  - Journal Article
PT  - Lecture
PT  - Review
PL  - England
TA  - Tissue Antigens
JT  - Tissue antigens
JID - 0331072
RN  - 0 (HLA Antigens)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Steroids)
SB  - IM
MH  - Adolescent
MH  - Cardiovascular Diseases/etiology/immunology/*mortality
MH  - Graft Survival
MH  - HLA Antigens/*immunology
MH  - Hip Fractures/etiology/immunology/*mortality
MH  - Histocompatibility Testing
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Kidney/drug effects/immunology
MH  - Kidney Transplantation/adverse effects/*mortality
MH  - Lymphoma, Non-Hodgkin/etiology/immunology/*mortality
MH  - Steroids/therapeutic use
MH  - Survival Analysis
MH  - Tissue Donors
OTO - NOTNLM
OT  - Collaborative Transplant Study
OT  - death with functioning graft
OT  - hip fracture
OT  - human leukocyte antigen
OT  - kidney transplantation
OT  - lymphoma
OT  - matching
OT  - mismatch
OT  - survival
EDAT- 2014/01/28 06:00
MHDA- 2014/09/16 06:00
CRDT- 2014/01/28 06:00
PHST- 2014/01/28 06:00 [entrez]
PHST- 2014/01/28 06:00 [pubmed]
PHST- 2014/09/16 06:00 [medline]
AID - 10.1111/tan.12147 [doi]
PST - ppublish
SO  - Tissue Antigens. 2013 Oct;82(4):235-42. doi: 10.1111/tan.12147.