| Autor: |
Marije C. Baas, Irma Joosten, Paul J M van der Boog, Michiel G. H. Betjes, Arnold van der Meer, Marianne C. Verhaar, Ineke J. M. ten Berge, Wil A. Allebes, Frans H.J. Claas, Johan W. de Fijter, Eric Spierings, Neelke C. van der Weerd, Kirsten Geneugelijk, Laura Bungener, Azam S. Nurmohamed, Dave L. Roelen, Bouke G. Hepkema, Luuk B. Hilbrands, Matthias Niemann, Maarten H. L. Christiaans, Marcel G.J. Tilanus, A. J. Hoitsma, Wendy Swelsen, Erik C Hack, Michiel L. Bots, Frederike J. Bemelman, Marc A. Seelen, Arjan D. van Zuilen, Sebastiaan Heidt, Annechien J. A. Lambeck, Franka E. van Reekum, Joris Vanderlocht, Julia Drylewicz, Karlijn A M I van der Pant, Neubury M. Lardy, Jan-Stefan Sanders, Lotte Wieten, Christien Voorter, M. Gelens, Elly M. van Duijnhoven, Frans J. van Ittersum, Elena G. Kamburova, Henny G. Otten |
| Rok vydání: |
2017 |
| Předmět: |
|
| Zdroj: |
Human Immunology. 78:39 |
| ISSN: |
0198-8859 |
| DOI: |
10.1016/j.humimm.2017.06.047 |
| Popis: |
Aim Individual HLA mismatches may have differential effects on graft survival after kidney transplantation. Therefore, there is a need for a reliable tool to define permissible HLA mismatches in kidney transplantation. We previously demonstrated that donor-derived Predicted Indirectly ReCognizable HLA epitopes presented by recipient HLA class-II (PIRCHE-II) play a role in de novo donor-specific HLA antibody formation after kidney transplantation. Moreover, we also showed that PIRCHE-II is involved in HLA antibody formation after pregnancy. In the present Dutch multi-center study we evaluated the possible association between PIRCHE-II and kidney graft failure in 2918 donor-recipient couples that were transplanted between 1995 and 2005. Methods For all donors-recipients couples, PIRCHE-II numbers were determined and related to graft survival in both univariate and multivariable analyses. Results Adjusted for confounders, the natural logarithm of PIRCHE-II was associated with a higher risk for graft failure (HR:1.13, 95% CI:1.04–1.23, p = 0.003). Univariately analyzed, patients with low PIRCHE-II numbers had a better 10-years graft survival than patients with higher PIRCHE-II numbers (p = 0.006; PIRCHE-II strata: Conclusions Our data suggest that the PIRCHE-II algorithm is a valuable tool to discriminate between permissible HLA mismatches and high-risk HLA mismatches in kidney transplantation. Inclusion of PIRCHE-II in donor-selection criteria may eventually lead to an improved kidney graft survival. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect