The impact of human leukocyte antigen mismatching on graft survival and mortality in adult renal transplantation

Shi, Xinmiao; Han, Wenxue; Ding, Jie

doi:10.1097/md.0000000000008899

Cited by 3 publications

(3 citation statements)

References 20 publications

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“…These agents suppress the immunogenic response of the recipients lymphocytes against transplanted human leukocyte antigens, to prevent immune-mediated rejection[ 147 ]. Therefore appropriate cross-matching is carried out prior to transplantation to prevent human leukocyte antigens-mismatch[ 148 ]. The alteration in the immune system with the use of immunosuppressant’s or introduction of foreign antigens could lead to a dysregulated immune response and subsequent development of autoimmune disorders.…”

Section: Post-transplant Secondary Ibdmentioning

confidence: 99%

Secondary causes of inflammatory bowel diseases

Ghouri¹,

Tahan²,

Shen³

2020

WJG

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Inflammatory bowel diseases (IBD), conventionally consist of Crohn’s disease (CD) and ulcerative colitis. They occur in individuals with high risk genotype for the disease in the setting of appropriate environmental factors. The pathogenesis of IBD involves a dysregulated autoimmune response to gut dysbiosis, which in turn is triggered due to exposure to various inciting environmental factors. But there is no clearly defined etiology of IBD and this type of disease is termed as “idiopathic IBD”, “classic IBD”, or “primary IBD”. We reviewed the current medical literature and found that certain etiological factors may be responsible for the development of IBD or IBD-like conditions, and we consider this form of de novo IBD as “secondary IBD”. Currently known factors that are potentially responsible for giving rise to secondary IBD are medications; bowel altering surgeries and transplantation of organs, stem cells or fecal microbiome. Medications associated with the development of secondary IBD include; immunomodulators, anti-tumor necrosis factor alpha agents, anti-interleukin agents, interferons, immune stimulating agents and checkpoint inhibitors. Colectomy can in some cases give rise to de novo CD, pouchitis of the ileal pouch, or postcolectomy enteritis syndrome. After solid organ transplantation or hematopoietic stem cell transplantation, the recipient may develop de novo IBD or IBD flare. Fecal microbiota transplantation has been widely used to treat patients suffering from recurrent Clostridium difficile infection but can also causes IBD flares.

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Section: Post-transplant Secondary Ibdmentioning

confidence: 99%

Secondary causes of inflammatory bowel diseases

Ghouri¹,

Tahan²,

Shen³

2020

WJG

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“…The outcome (the dependent variable) was renal function (either increased or decreased). As of 19 September 2019 there is no review protocol for studies of HLA and renal function (as per a search of PROSPERO), though there is one for studies of HLA mismatches and kidney transplant outcomes (Shi et al., 2017 ).…”

Section: Methodsmentioning

confidence: 99%

Systematic review of associations between HLA and renal function

Lowe

Jervis

Payton

et al. 2021

Int J Immunogenetics

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Introduction: Kidney dysfunction is a highly significant disease, both in the United Kingdom and globally. Many previous studies have reported associations between human leukocyte antigens (HLA) and renal function; this systematic review attempts to identify, summarize and appraise all published studies of these associations.Methods: A literature search was performed using Medline, Embase and Cochrane Central Register of Controlled Trials to identify papers whose keywords included each of the following concepts: HLA, renal failure and genetic association. A total of 245 papers were identified and assessed for eligibility; 35 of these were included in the final study.Results: A total of 95 HLA types and 14 three-locus haplotypes were reported to be associated with either increased or decreased renal function. A number of these findings were replicated by independent studies that reported 16 types were protective against renal dysfunction and 15 types were associated with reduced renal function.A total of 20 HLA types were associated with both increased risk of renal disease and decreased risk by independent studies. Discussion: There is very little consensus on which HLA types have a protective or deleterious effect on renal function. Ethnicity may play a role, with HLA types possibly having different effects among different populations, and it is possible that the different primary diseases that lead to ESRD may have different HLA associations. Some of the studies may contain type I and type II errors caused by insufficient sample sizes, cohort selection and statistical methods. Although we have compiled a comprehensive list of published associations between renal function and HLA, in many cases, it is unclear which associations are reliable. Further studies are required to confirm or refute these findings.

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“…Operative hepatic venous reconstruction during liver transplant, done in children who are recipients of liver grafts, is expected to meet current flow, and to meet future remodeling. Future remodeling is a need to accommodate flow required by the growth in size of the children as they attain their adult height, weight and size (9,10). We made the diagnosis of CHVOI in 7 children recipients of living related liver transplant, based upon the findings on magnetic resonance venography (MRV) and interventional radiogram of hepatic vessels.…”

Section: Introductionmentioning

confidence: 99%

Chronic Hepatic Venous Ischemia Secondary to Venous Outflow Insufficiency Causes Chronic Rejection in Pediatric Liver Transplant Recipients

Kotb

Gharib

Kader

et al. 2022

Pediatric Sciences Journal

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Background: Venous ischemia in a closed compartment results in congestion, impeded blood supply, cell death and a cascade of events that involves immune system to remove cellular debris. Aim of the Work:To report our experience with chronic hepatic venous ischemia post liver transplant. Methods: We describe 3 girls and 4 boys with chronic hepatic venous ischemia secondary to chronic hepatic venous outflow insufficiency (CHVOI) post-liver transplant as confirmed by magnetic resonance venography (MRV) and by interventional radiograms. Results:The mean age at transplantation was 6.75 years. Following transplant, within 8.5±1.7 months they presented with progressive jaundice, ascites and hepatosplenomegaly. Imaging showed features consistent of CHVOI. The percutaneous liver biopsy revealed a picture of predominant chronic rejection and not of venous congestion. They improved clinically following hepatic venous dilation but not with change of type or dose of immuno-suppression. The venousoutflow tightness recurred with unsustained clinical improvement. Two children had stent placement. All others had irreversible progressive course developing end-stage liver disease. All were indicated for re-transplant. Of them 5 died awaiting re-transplant. Conclusions: Chronic rejection among our studied children was due to insufficient intraoperative hepatic venous-outflow structural construction. CHVOI in children leads to graft loss and presents as chronic rejection. CHVOI should be ruled out in any child presenting with chronic rejection. Very generous hepatic venous outflow surgical construction technique should be planned, individualized and secured during liver transplant procedure. Stent placement is life-saving. Changes of immunosuppression medications is ineffective Level of Evidence of Study: IIB (1).

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The impact of human leukocyte antigen mismatching on graft survival and mortality in adult renal transplantation

Cited by 3 publications

References 20 publications

Secondary causes of inflammatory bowel diseases

Secondary causes of inflammatory bowel diseases

Systematic review of associations between HLA and renal function

Chronic Hepatic Venous Ischemia Secondary to Venous Outflow Insufficiency Causes Chronic Rejection in Pediatric Liver Transplant Recipients

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