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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 BMC+Nephrol
2018 ; 19
(1
): 116
Nephropedia Template TP
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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
#MMPMID29776389
Shi X
; Lv J
; Han W
; Zhong X
; Xie X
; Su B
; Ding J
BMC Nephrol
2018[May]; 19
(1
): 116
PMID29776389
show ga
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.