Khongjaroensakun N, Kitpoka P, Wiwattanathum P, Sakulchairungrueng B, Thammanichanond D
Histocompatibility and Immunogenetics Laboratory, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Division of Nephrology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Transplant Proc. 2018 Oct;50(8):2371-2376. doi: 10.1016/j.transproceed.2018.02.187. Epub 2018 Mar 20.
HLA matching at the A, B, and DR loci influences the graft survival rate of deceased donor kidney transplants. The effect of HLA-DQB1 matching on transplant outcomes is still controversial. The aim of this study was to investigate the association of HLA-DQB1 matching with allograft outcomes in deceased donor kidney transplant recipients.
A retrospective analysis of deceased donor kidney transplant recipients between 2008 and 2014 at the Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand, was performed. Donor-recipient HLA matching at DQB1 locus was analyzed. The association between HLA-DQB1 mismatches and transplant outcomes was investigated using adjusted Cox regression analysis.
A total of 383 deceased donor kidney transplants were performed during the study period, of which 297 with complete clinical and laboratory data were analyzed. The median follow-up time of all patients was 41 months (range, 16.4-65.6 months). Of the 297 recipients, 107 (36.03%) received 0 HLA-DQB1 mismatched kidneys and 190 (63.97%) received 1 or 2 HLA-DQB1 mismatched kidneys. Recipients who have received 1 or 2 HLA-DQB1 mismatched kidneys had a higher risk of acute rejection, with the adjusted hazard ratio of 4.35 (95% CI, 1.41-13.42; P = .01). However, HLA-DQB1 mismatching was not associated with chronic rejection and graft survival.
Donor-recipient HLA-DQB1 mismatching is associated with acute rejection in deceased donor kidney transplants. However HLA-DQB1 mismatching does not have a negative impact on chronic rejection or graft survival.
A、B和DR位点的HLA配型会影响 deceased 供体肾移植的移植物存活率。HLA - DQB1配型对移植结果的影响仍存在争议。本研究的目的是调查HLA - DQB1配型与 deceased 供体肾移植受者的同种异体移植物结果之间的关联。
对泰国曼谷拉玛提波迪医院医学院2008年至2014年期间的 deceased 供体肾移植受者进行回顾性分析。分析了供体 - 受体在DQB1位点的HLA配型。使用校正后的Cox回归分析研究HLA - DQB1错配与移植结果之间的关联。
在研究期间共进行了383例 deceased 供体肾移植，其中297例具有完整临床和实验室数据的患者被纳入分析。所有患者的中位随访时间为41个月（范围16.4 - 65.6个月）。在297例受者中，107例（36.03%）接受了0个HLA - DQB1错配的肾脏，190例（63.97%）接受了1个或2个HLA - DQB1错配的肾脏。接受1个或2个HLA - DQB1错配肾脏的受者发生急性排斥反应的风险更高，校正后的风险比为4.35（95%CI，1.41 - 13.42；P = 0.01）。然而，HLA - DQB1错配与慢性排斥反应和移植物存活无关。
供体 - 受体HLA - DQB1错配与 deceased 供体肾移植中的急性排斥反应相关。然而，HLA - DQB1错配对慢性排斥反应或移植物存活没有负面影响。
