PMID- 28564531
OWN - NLM
STAT- MEDLINE
DCOM- 20180723
LR  - 20181202
IS  - 0890-9016 (Print)
IS  - 0890-9016 (Linking)
VI  - 32
DP  - 2016
TI  - Acute Rejection in 6-Antigen HLA-Matched Kidney Transplant Recipients: Risk 
      Factors and Outcomes from the Wisconsin Allograft Recipient Database (WisARD).
PG  - 135-141
AB  - Acute rejection in human leukocyte antigen (HLA)-matched kidney transplant 
      recipients is uncommon and the mechanisms involved are not well understood. Data 
      from 6-antigen HLA-matched recipients transplanted between 1994 and 2014 were 
      analyzed to identify the incidence, risk factors, and outcomes associated with 
      biopsy-proven acute rejection (BPAR). A total of 278 HLA-matched recipients were 
      identified, of which, 155 (55.8%) received a graft from a sibling donor. Ten 
      patients (3.6%) experienced BPAR over a median follow-up of 10 years (0.41 cases 
      per 100 person-years). Median time to rejection was 36.5 months (standard 
      deviation +/-56.4). Recipients who experienced rejection did not differ from those 
      who did not in terms of age, gender, ethnicity, induction agent, panel reactive 
      antibody, or sensitizing events. Acute cellular, antibody-mediated, and mixed 
      rejection occurred in 5, 3, and 2 patients, respectively. The most common biopsy 
      classification was Banff IA (n=4). Four out of 10 patients had documented 
      nonadherence to maintenance immunosuppression. Thirty percent of HLA-matched 
      recipients who rejected had graft loss and 10% died, compared to 30.8% graft loss 
      and 28.4% deaths in non-rejectors (p=0.57 and 0.20, respectively). In conclusion, 
      acute cellular and antibody-mediated rejection are infrequent in HLA-matched 
      kidney transplant recipients. Nonadherence appears to be relatively common among 
      those experiencing rejection. Acute rejection was not associated with higher 
      graft loss or death. The pathogenesis of acute rejection in HLA-matched 
      recipients remains to be determined.
CI  - Copyright(c) 2017 by the Terasaki Research Institute.
FAU - Condon, Amanda J
AU  - Condon AJ
AD  - Department of Pharmacy, UW Health, Madison, WI.
FAU - Astor, Brad C
AU  - Astor BC
AD  - Division of Nephrology, Department of Medicine, University of Wisconsin - Madison 
      School of Medicine and Public Health, Madison, WI.
AD  - Department of Population Health Sciences, University of Wisconsin - Madison 
      School of Medicine and Public Health, Madison, WI.
FAU - Holdener, Kimberly E
AU  - Holdener KE
AD  - Department of Pharmacy, UW Health, Madison, WI.
FAU - Ellis, Thomas M
AU  - Ellis TM
AD  - Pathology and Lab Medicine, University of Wisconsin - Madison School of Medicine 
      and Public Health, Madison, WI.
FAU - Djamali, Arjang
AU  - Djamali A
AD  - Division of Nephrology, Department of Medicine, University of Wisconsin - Madison 
      School of Medicine and Public Health, Madison, WI.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Clin Transpl
JT  - Clinical transplants
JID - 8812419
SB  - IM
MH  - *Allografts
MH  - *Graft Rejection
MH  - Graft Survival
MH  - Humans
MH  - *Kidney Transplantation
MH  - Risk Factors
OTO - NOTNLM
OT  - HLA-matched
OT  - biopsy-proven acute rejection
OT  - kidney
OT  - transplantation
EDAT- 2016/01/01 00:00
MHDA- 2018/07/24 06:00
CRDT- 2017/06/01 06:00
PHST- 2017/06/01 06:00 [entrez]
PHST- 2016/01/01 00:00 [pubmed]
PHST- 2018/07/24 06:00 [medline]
PST - ppublish
SO  - Clin Transpl. 2016;32:135-141.