PMID- 29776389
OWN - NLM
STAT- MEDLINE
DCOM- 20190527
LR  - 20190527
IS  - 1471-2369 (Electronic)
IS  - 1471-2369 (Linking)
VI  - 19
IP  - 1
DP  - 2018 May 18
TI  - What is the impact of human leukocyte antigen mismatching on graft survival and 
      mortality in renal transplantation? A meta-analysis of 23 cohort studies 
      involving 486,608 recipients.
PG  - 116
LID - 10.1186/s12882-018-0908-3 [doi]
LID - 116
AB  - BACKGROUND: The magnitude effects of human leukocyte antigen (HLA) mismatching on 
      post-transplant outcomes of kidney transplantation remain controversial. We aim 
      to quantitatively assess the associations of HLA mismatching with graft survival 
      and mortality in adult kidney transplantation. METHODS: We searched PubMed, 
      EMBASE and the Cochrane Library from their inception to December, 2016. Priori 
      clinical outcomes were overall graft failure, death-censored graft failure and 
      all-cause mortality. RESULTS: A total of 23 cohort studies covering 486,608 
      recipients were selected. HLA per mismatch was significant associated with 
      increased risks of overall graft failure (hazard ratio (HR), 1.06; 95% confidence 
      interval (CI), 1.05-1.07), death-censored graft failure (HR: 1.09; 95% CI 
      1.06-1.12) and all-cause mortality (HR: 1.04; 95% CI: 1.02-1.07). Besides, HLA-DR 
      mismatches were significant associated with worse overall graft survival (HR: 
      1.12, 95% CI: 1.05-1.21). For HLA-A locus, the association was insignificant (HR: 
      1.06; 95% CI: 0.98-1.14). We observed no significant association between HLA-B 
      locus and overall graft failure (HR: 1.01; 95% CI: 0.90-1.15). In subgroup 
      analyses, we found recipient sample size and ethnicity maybe the potential 
      sources of heterogeneity. CONCLUSIONS: HLA mismatching was still a critical 
      prognostic factor that affects graft and recipient survival. HLA-DR mismatching 
      has a substantial impact on recipient's graft survival. HLA-A mismatching has 
      minor but insignificant impact on graft survival outcomes.
FAU - Shi, Xinmiao
AU  - Shi X
AD  - Department of Pediatrics, Peking University First Hospital, 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 
      Unversity, 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 - 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 
      Unversity, Ministry of Education, Beijing, China.
FAU - Su, Baige
AU  - Su B
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. 
      djnc_5855@126.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20180518
PL  - England
TA  - BMC Nephrol
JT  - BMC nephrology
JID - 100967793
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Cohort Studies
MH  - Graft Survival/*physiology
MH  - HLA Antigens/*blood/genetics
MH  - Histocompatibility Testing/*mortality/trends
MH  - Humans
MH  - Kidney Transplantation/*mortality/trends
MH  - Mortality/trends
MH  - *Transplant Recipients
PMC - PMC5960106
OTO - NOTNLM
OT  - Graft survival
OT  - Human leukocyte antigen
OT  - Kidney transplantation
OT  - Meta-analysis
OT  - Mortality
COIS- COMPETING INTERESTS: The authors declare that they have no competing interests. 
      PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional 
      claims in published maps and institutional affiliations.
EDAT- 2018/05/20 06:00
MHDA- 2019/05/28 06:00
PMCR- 2018/05/18
CRDT- 2018/05/20 06:00
PHST- 2017/10/01 00:00 [received]
PHST- 2018/04/26 00:00 [accepted]
PHST- 2018/05/20 06:00 [entrez]
PHST- 2018/05/20 06:00 [pubmed]
PHST- 2019/05/28 06:00 [medline]
PHST- 2018/05/18 00:00 [pmc-release]
AID - 10.1186/s12882-018-0908-3 [pii]
AID - 908 [pii]
AID - 10.1186/s12882-018-0908-3 [doi]
PST - epublish
SO  - BMC Nephrol. 2018 May 18;19(1):116. doi: 10.1186/s12882-018-0908-3.