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Página principal > Artículos > Artículos publicados > Impact of HLA Mismatching on Early Subclinical Inflammation in Low-Immunological-Risk Kidney Transplant Recipients |
Fecha: | 2021 |
Resumen: | The impact of human leukocyte antigen (HLA)-mismatching on the early appearance of subclinical inflammation (SCI) in low-immunological-risk kidney transplant (KT) recipients is undetermined. We aimed to assess whether HLA-mismatching (A-B-C-DR-DQ) is a risk factor for early SCI. As part of a clinical trial (Clinicaltrials. gov, number NCT02284464), a total of 105 low-immunological-risk KT patients underwent a protocol biopsy on the third month post-KT. As a result, 54 presented SCI, showing a greater number of total HLA-mismatches (p = 0. 008) and worse allograft function compared with the no inflammation group (48. 5 ± 13. 6 vs. 60 ± 23. 4 mL/min; p = 0. 003). Multiple logistic regression showed that the only risk factor associated with SCI was the total HLA-mismatch score (OR 1. 32, 95%CI 1. 06-1. 64, p = 0. 013) or class II HLA mismatching (OR 1. 51; 95%CI 1. 04-2. 19, p = 0. 032) after adjusting for confounder variables (recipient age, delayed graft function, transfusion prior KT, and tacrolimus levels). The ROC curve illustrated that the HLA mismatching of six antigens was the optimal value in terms of sensitivity and specificity for predicting the SCI. Finally, a significantly higher proportion of SCI was seen in patients with >6 vs. ≤6 HLA-mismatches (62. 3 vs. 37. 7%; p = 0. 008). HLA compatibility is an independent risk factor associated with early SCI. Thus, transplant physicians should perhaps be more aware of HLA mismatching to reduce these early harmful lesions. |
Ayudas: | Instituto de Salud Carlos III ICI14/0016 Instituto de Salud Carlos III PI17/02043 Instituto de Salud Carlos III CM19-00210 Instituto de Salud Carlos III RD16/0009/0006 Instituto de Salud Carlos III RD16/0009/0003 Instituto de Salud Carlos III RD16/0009/0030 Instituto de Salud Carlos III RD16/0009/0031 |
Derechos: | Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. |
Lengua: | Anglès |
Documento: | Article ; recerca ; Versió publicada |
Materia: | Kidney transplantation ; HLA compatibility ; Subclinical inflammation ; Banff criteria ; Low-immunological risk |
Publicado en: | Journal of clinical medicine, Vol. 10 (april 2021) , ISSN 2077-0383 |
10 p, 705.4 KB |