INFLUENCE OF THE Rh (D) BLOOD GROUP SYSTEM ON GRAFT SURVIVAL IN RENAL TRANSPLANTATION

Bryan, Christopher; Mitchell, Stanley I.; Lin, Hung Mo; Nelson, Paul W.; Shield, Charles F.; Luger, Alan M.; Pierce, George E.; Ross, Gilbert; Warady, Bradley A.; Aeder, Mark I.; Helling, Thomas S.; Landreneau, Michael D.; Harrell, Kevin M.

doi:10.1097/00007890-199802270-00026

Cited by 11 publications

(10 citation statements)

References 6 publications

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“…Bryan et al [62] investigated the effect of Rh mismatch on the outcome of kidney transplantation. They reported poorer 7-year graft survival in cases of Rh mismatched transplantation.…”

Section: Rhesus Factor Mismatchmentioning

confidence: 99%

Matching donor to recipient in liver transplantation: Relevance in clinical practice

Reddy¹,

Varghese²,

Venkataraman³

et al. 2013

WJH

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Achieving optimum outcomes after liver transplantation requires an understanding of the interaction between donor, graft and recipient factors. Within the cohort of patients waiting for a transplant, better matching of the donor organ to the recipient will improve transplant outcomes and benefit the overall waiting list by minimizing graft failure and need for re-transplantation. A PubMed search was conducted to identify published literature investigating the effects of donor factors such as age, gender, ethnicity, viral serology; graft factors such as size and quality, recipient factors such as age, size, gender and transplant factors such as major or minor blood group incompatibility and immunological factors. We also report technical and therapeutic modifications that can be used to manage donor-recipient mismatch identified from literature and the authors' clinical experience. Multiple donor and recipient factors impact graft survival after liver transplantation. Appropriate matching based on donor-organ-recipient variables, modification of surgical technique and innovative peri-transplant strategies can increase the donor pool by utilizing grafts from marginal donors that are traditionally turned down.

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“…Bryan et al [62] investigated the effect of Rh mismatch on the outcome of kidney transplantation. They reported poorer 7-year graft survival in cases of Rh mismatched transplantation.…”

Section: Rhesus Factor Mismatchmentioning

confidence: 99%

Matching donor to recipient in liver transplantation: Relevance in clinical practice

Reddy¹,

Varghese²,

Venkataraman³

et al. 2013

WJH

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“…20 Moreover, most of our patients received their renal allografts from donors with the same or matched blood group and therefore, we found no significant effect of blood group on acute rejection episodes or their steroid responsiveness among the groups (P = .532). Over the last 10 years, most transplant centers do not routinely give pretransplant transfusions because of the widespread use of erythropoietin, concerns about the risk of transfusion-related infections, and sensitization.…”

Section: Discussionmentioning

confidence: 64%

Risk Factors for Steroid-Resistant T-Cell–Mediated Acute Cellular Rejection and Their Effect on Kidney Graft and Patient Outcome

Awadain

Gheith²,

Hassan³

et al. 2012

Exp Clin Transplant

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Objectives: Acute rejection in renal transplant is considered a risk factor for short-term and long-term allograft survival. The expected reversal rate for the first acute cellular rejection, by steroid pulse, ranges between 60% and 100%, and lack of improvement within 1 week of treatment is defined as steroidresistant rejection. This work sought to evaluate factors that lead to steroid-resistant acute cellular rejection among patients with first live-donor renal allotransplant and its effect on graft and patient survival. Materials and Methods:Patients with an improvement in serum creatinine levels were considered controls (group 1; n=100); while the others were considered an early steroid-resistant group (group 2; n=99). Both groups were matched demographically. Results: Patients with a target cyclosporine level below accepted therapeutic levels were significantly higher in group 2 (P = .02). We found no significant differences between the groups regarding posttransplant complications (P > .05). Mean hospital stay was longer in group 2 (P = .021). Living patients with functioning graft were more prevalent in group 1, while those alive on dialysis were more prevalent in group 2. The groups were comparable regarding long-term patient and graft survival despite significantly lower creatinine values in patients of group 1 at 6 months' follow-up (P ≤ .001).Conclusions: Prebiopsy low cyclosporine trough levels and associated chronic changes among patients who were maintained on calcineurin inhibitor-based regimens represented the most-important risk factors for the early steroid-resistant group. Rescue therapies improve short-term graft outcome; however, they did not affect either patient or long-term graft survival after 5 years' follow-up.

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“…A humoral mechanism, disparity of the other two Rh antigens (Cc and Ee) and two Rh-associated glycoproteins encoded by genes mapped on chromosome 6, was suggested to explain this chronic rejection not only in the RhϮ group but also in the (RhϪ/ϩ subset of patients (3). Our data clearly demonstrate the absence of the prevalence of acute or chronic rejection in either group on long-term evaluation.…”

mentioning

confidence: 46%

“…In a unique report, Bryan et al demonstrated that Rh identity between recipient and donor was significantly related to better long-term graft outcome by multivariate analysis in primary cadaveric renal transplantation. Interestingly, they could not prove this impact in cadaveric regrafts or live donor transplants (3). Nevertheless, this study was a multicenter study and included a heterogeneous patient population, and its conclusion could not be reproduced on evaluation of a wider database (i.e., the United Network for Organ Sharing).…”

mentioning

confidence: 85%

“…Historically, a worse outcome for Rh-mismatched recipients-Rh(D)-positive donor into a Rh(D)-negative recipient-was seen at 12 months posttransplant, but this effect could not be demonstrated in the cyclosporine era (2). Recent reports have indicated that an Rh(D) mismatch had a negative impact on long-term graft survival in cadaveric renal transplantation (3). The impact of challenging the Rh(D) barrier on long-term graft function and survival in the living setting has not been previously reported.…”

mentioning

confidence: 98%

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Impact of Rh(D) Blood Group System on Graft Function and Survival in Live-Donor Kidney Transplantation: A Single-Institution Experience

et al. 2004

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One thousand five hundred consecutive live-donor renal transplants were performed in a single institution. Among these patients, 1,372 patients (group I) received Rh-identical allografts and 128 (group II) received Rh-nonidentical allografts. The two groups were homogenous apart from the prevalence of the Rh nonidentity among unrelated donor-recipient pairs. The rate of acute and chronic rejection was comparable in both groups (P = 0.33 for acute rejection and P = 0.66 for chronic rejection). The mean serum creatinine at 5 years was 1.8 +/- 1 mg/dL for group I and 1.7 +/- 0.9 mg/dL for group II (P = 0.5). The 1-, 5-, and 10-year graft survival rates were 94%, 78%, and 54% for group I and 95%, 82%, and 57% for group II. We found that the Rh(D) blood group system is not likely to be a clinically relevant histocompatibility barrier to live-donor renal transplantation.

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INFLUENCE OF THE Rh (D) BLOOD GROUP SYSTEM ON GRAFT SURVIVAL IN RENAL TRANSPLANTATION

Abstract: Multivariate analysis of primary cadaveric renal allografts performed within the Midwest Organ Bank OPO indicates that Rh (D) is a clinically relevant histocompatibility barrier that influences 7-year graft survival.

Cited by 11 publications

References 6 publications

Matching donor to recipient in liver transplantation: Relevance in clinical practice

Matching donor to recipient in liver transplantation: Relevance in clinical practice

Risk Factors for Steroid-Resistant T-Cell–Mediated Acute Cellular Rejection and Their Effect on Kidney Graft and Patient Outcome

Impact of Rh(D) Blood Group System on Graft Function and Survival in Live-Donor Kidney Transplantation: A Single-Institution Experience

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