HLA mismatch is important for 20-year graft survival in kidney transplant patients |
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| Affiliation: | 1. The Aga Khan University - Medical College, The Aga Khan University, Karachi, Pakistan;2. Baylor College of Medicine, Houston, TX, United States of America;3. New York University School of Medicine, Department of Internal Medicine, United States of America;4. Division of Nephrology and Abdominal Transplantation, Department of Medicine, Baylor College of Medicine, Houston, TX, United States of America;5. Division of Abdominal Transplantation, Department of Surgery, Baylor College of Medicine, Houston, TX, United States of America.;1. Department of Transfusion Medicine, Histocompatibility and Molecular Biology, Jaypee Hospital, Noida, UP 201301, India;2. Department of Histocompatibility and Molecular Biology, Jaypee Hospital, Noida,UP 201301, India;3. Department of Transfusion Medicine, Jaypee Hospital, Noida, UP 201301, India;4. Kidney Transplant Programme, Department of Urology and Kidney Transplant, Jaypee Hospital, Noida, UP 201301, India;5. Department of Nephrology and Kidney Transplant, Jaypee Hospital, Noida, UP 201301, India;1. Istanbul University, Istanbul Faculty of Medicine, Department of Medical Biology, Tissue Typing Laboratory, Istanbul-Turkiye, Millet street Fatih, Istanbul 34093, Turkey;2. Istanbul University, Institute of Health Sciences/Medical Biology, Istanbul, Turkiye;1. State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China;2. Department of Hematology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China;3. Department of Hematology, Qingdao Central Hospital, Qingdao, China;1. Klinik am See, Rehabilitationszentrum, Rüdersdorf, Germany;2. Medical University Brandenburg "Theodor Fontane", Germany;3. Universität Potsdam, Professur für Rehabilitationswissenschaften, humanwissenschaftliche Fakultät, Germany;4. Clinic of Dermatology, Immunology and Allergology, Medical Center Dessau, Medical University Brandenburg "Theodor Fontane" Medical Center Dessau, Germany;1. School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran;2. Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran;1. Institute of Environmental Science and Research, Ain Shams University, Cairo, EG;2. Faculty of Pharmacy, Suez Canal University EG;3. Faculty of Science, Al-Azhar University EG;4. Faculty of Pharmacy, Al Azhar University EG;5. Faculty of Medicine for Girls, Al Azhar University EG |
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| Abstract: | ![]()
BackgroundHuman leukocyte antigens (HLA) matching is gradually being omitted from clinical practice in evaluation for renal allograft transplant. While such practices may yield shorter wait times and adequate short-term outcomes, graft longevity in HLA mismatched patients remains unclear. This study aims to demonstrate that HLA matching may still play an important role in long-term graft survival.MethodsWe identified patients undergoing an index kidney transplant in the United Network for Organ Sharing (UNOS) data from 1990 to 1999, with one-year graft survival. The primary outcome of the analysis was graft survival beyond 10 years. We explored the long-lasting impact of HLA mismatches by landmarking the analysis at established time points.ResultsWe identified 76,530 patients receiving renal transplants in the time frame, 23,914 from living donors and 52,616 from deceased donors. On multivariate analysis, more HLA mismatches were associated with worse graft survival beyond 10 years for both living and deceased donor allografts. HLA mismatch continued to remain an essential factor in the long term.ConclusionsA greater number of HLA mismatches was associated with progressively worse long-term graft survival for patients. Our analysis reinforces the importance of HLA matching in the preoperative evaluation of renal allografts. |
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