PMID- 28992320
OWN - NLM
STAT- MEDLINE
DCOM- 20180518
LR  - 20220330
IS  - 1460-2385 (Electronic)
IS  - 0931-0509 (Linking)
VI  - 32
IP  - 11
DP  - 2017 Nov 1
TI  - Effect of human leukocyte antigen mismatching on the outcomes of pediatric kidney 
      transplantation: a systematic review and meta-analysis.
PG  - 1939-1948
LID - 10.1093/ndt/gfx259 [doi]
AB  - BACKGROUND: Kidney transplantation is regarded as the optimal treatment for 
      pediatric patients with end-stage renal disease. Here, we address a controversial 
      topic in pediatric kidney transplantation by performing a quantitative evaluation 
      of the effect of human leukocyte antigen (HLA) mismatching on the outcomes of 
      pediatric kidney transplantation. METHODS: We systematically searched PubMed, 
      EMBASE and the Cochrane Library from their inception to 31 December 2016 for 
      cohort studies assessing the risk ratio (RR) of HLA mismatching on pediatric 
      kidney transplantation. Outcome measures included graft failure, rejection and 
      all-cause mortality. RRs and 95% confidence intervals (CIs) were used as 
      estimates of effect size in random-effect models. RESULTS: Eighteen studies 
      comprising a total of 26 018 pediatric recipients were included in the 
      evaluation. Compared with 0-1 HLA-DR mismatch, 2 mismatches significantly 
      increased the risk of graft failure at 1 year (RR: 1.41, 95% CI: 1.11-1.80), 
      3 years (RR: 1.28, 95% CI: 1.08-1.52), 5 years (RR: 1.21, 95% CI: 1.04-1.41) and 
      10 years (RR: 1.30, 95% CI: 1.02-1.67). For HLA-A + B, the 5-year graft failure 
      risk was higher for 2-4 mismatches compared with 0-1 mismatch (RR: 3.17, 95% CI: 
      1.20-8.36), but not for 3-4 compared with 0-2 mismatches (RR: 1.49, 95% CI: 
      0.79-2.80). CONCLUSIONS: Based on pooled analysis, HLA-DR and HLA-A + B are 
      important factors affecting post-transplant outcomes, especially graft failure, 
      in pediatric recipients. Additional randomized controlled trials with higher 
      quality evidence are needed for further investigation.
CI  - (c) The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. 
      All rights reserved.
FAU - Shi, Xinmiao
AU  - Shi X
AD  - Department of Pediatrics, Peking University First Hospital, Beijing, China.
FAU - Liu, Rui
AU  - Liu R
AD  - Heart Center, The First Hospital of Tsinghua University, Tsinghua University, 
      Beijing, China.
AD  - Medical Center, Tsinghua University, Beijing, China.
FAU - Xie, Xinfang
AU  - Xie X
AD  - Renal Division, Peking University First Hospital, Beijing, China.
AD  - Peking University Institute of Nephrology, Beijing, China.
AD  - Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.
AD  - Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Peking 
      University, Ministry of Education, Beijing, China.
FAU - Lv, Jicheng
AU  - Lv J
AD  - Renal Division, Peking University First Hospital, Beijing, China.
AD  - Peking University Institute of Nephrology, Beijing, China.
AD  - Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.
AD  - Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Peking 
      University, Ministry of Education, Beijing, China.
FAU - Han, Wenke
AU  - Han W
AD  - Institute of Urology, Peking University, Beijing, China.
AD  - Department of Urology, Peking University First Hospital, Beijing, China.
FAU - Zhong, Xuhui
AU  - Zhong X
AD  - Department of Pediatrics, Peking University First Hospital, Beijing, China.
FAU - Ding, Jie
AU  - Ding J
AD  - Department of Pediatrics, Peking University First Hospital, Beijing, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
RN  - 0 (HLA-A Antigens)
RN  - 0 (HLA-B Antigens)
RN  - 0 (HLA-DR Antigens)
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Graft Rejection/immunology
MH  - Graft Survival/immunology
MH  - HLA-A Antigens/immunology
MH  - HLA-B Antigens/immunology
MH  - HLA-DR Antigens/immunology
MH  - Humans
MH  - Kidney Diseases/*surgery
MH  - *Kidney Transplantation
MH  - Odds Ratio
MH  - Transplantation Immunology
MH  - Treatment Outcome
OTO - NOTNLM
OT  - children
OT  - graft failure
OT  - human leukocyte antigen
OT  - kidney transplantation
OT  - meta-analysis
EDAT- 2017/10/11 06:00
MHDA- 2018/05/19 06:00
CRDT- 2017/10/10 06:00
PHST- 2017/05/23 00:00 [received]
PHST- 2017/07/05 00:00 [accepted]
PHST- 2017/10/11 06:00 [pubmed]
PHST- 2018/05/19 06:00 [medline]
PHST- 2017/10/10 06:00 [entrez]
AID - 4092869 [pii]
AID - 10.1093/ndt/gfx259 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2017 Nov 1;32(11):1939-1948. doi: 10.1093/ndt/gfx259.