Minor Histocompatibility Antigens as Risk Factor for Poor Prognosis in Kidney Transplantation

Pabón, Maria; Navarro, Cristian Eduardo; Martin, Roger; Rodríguez, M.; Martin, Ivan; Gaitán, L.; Gómez, Álvaro Díaz; Lozano, E.

doi:10.1016/j.transproceed.2011.09.007

Cited by 14 publications

(12 citation statements)

References 44 publications

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“…From an immunological perspective, females are considered to be more immunocompetent than males as demonstrated by a higher incidence of autoimmune diseases and increased cardiac allograft rejection . In addition, the presence of a minor histocompatibility antigen on the Y chromosome may adversely affect females , as has been shown in kidney transplant recipients .…”

Section: Discussionmentioning

confidence: 98%

Impact of donor–recipient sex match on long‐term survival after heart transplantation in children: An analysis of 5797 pediatric heart transplants

Kemna

Albers

Bradford

et al. 2015

Pediatric Transplantation

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The effect of donor-recipient sex matching on long-term survival in pediatric heart transplantation is not well known. Adult data have shown worse survival when male recipients receive a sex-mismatched heart, with conflicting results in female recipients. We analyzed 5795 heart transplant recipients ≤ 18 yr in the Scientific Registry of Transplant Recipients (1990-2012). Recipients were stratified based on donor and recipient sex, creating four groups: MM (N = 1888), FM (N = 1384), FF (N = 1082), and MF (N = 1441). Males receiving sex-matched donor hearts had increased unadjusted allograft survival at five yr (73.2 vs. 71%, p = 0.01). However, this survival advantage disappeared with longer follow-up and when adjusted for additional risk factors by multivariable Cox regression analysis. In contrast, for females, receiving a sex-mismatched heart was associated with an 18% higher risk of allograft loss over time compared to receiving a sex-matched heart (HR 1.18, 95% CI: 1.00-1.38) and a 26% higher risk compared to sex-matched male recipients (HR 1.26, 95% CI: 1.10-1.45). Females who receive a heart from a male donor appear to have a distinct long-term survival disadvantage compared to all other groups.

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Section: Discussionmentioning

confidence: 98%

Impact of donor–recipient sex match on long‐term survival after heart transplantation in children: An analysis of 5797 pediatric heart transplants

Kemna

Albers

Bradford

et al. 2015

Pediatric Transplantation

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“…Even though non-HLA (Human Leukocyte Antigen) mismatches might not be currently in the centre of attention, minor histocompatibility antigens, such as H-Y, affect the outcomes of transplantation and Y-linked antigens might explain poorer outcomes in female recipients of male grafts (18,(21)(22)(23).…”

Section: Discussionmentioning

confidence: 99%

Gender Differences in Kidney Transplantation – 10-Year Retrospective Study

Kováčiková

Beňa

Lacková

et al. 2018

Acta Medica Martiniana

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Background: Chronic kidney disease represents a world-wide health problem affecting approximately 195 million women around the world. Risk of development of chronic kidney disease is greater in women; therefore, the World Kidney Day 2018 was dedicated to kidney disease, treatment options, and its specifics in female patients. Materials and Methods: We retrospectively analysed a cohort of 1,457 patients after kidney transplantation from all transplant centres in Slovakia over a period of ten years from 2005 – 2015.The parameters taken into account were cause of end-stage renal disease (ESRD), outcome of transplantation in a context of differences between the genders. Results: During the ten-year period there were 557 transplanted women vs. 900 men. Among female recipient the dominant cause of ESRD was tubulointerstitial nephritis (males 22.3% vs. females 32.1%, p < 0.0001), other causes of ESRD where females were significantly more represented than men included polycystic kidney disease (males 11.6% vs. females 17.6%, p = 0.0013) and systemic lupus erythematosus (males 0.2% vs. females 2.3 %, p = 0.0001). There was no significant difference in 12-month, 5-year, and 10-year both graft and patient survival rates between men and women. Female recipients wait for kidney transplantation significantly longer in spite of comparable time spent on dialysis (males 32.9 months vs. females 39.4 months, p < 0.0001). Conclusion: Despite comparable patient and graft survival rates in male and female recipients in our study there are other studies showing that gender as well as gender mismatch significantly influence the outcomes of transplantation.

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“…These data suggest that alterations in the extra-renal environment enhanced inflammatory responses, which may be significant in long-term graft function and could have potential translational significance in human KTXs. It should be noted that minor histocompatibility antigen rejection, in which female recipients reject grafts from the male donors due to incompatibility with the male H-Y antigen, 48,49 may be one of the factors that induce higher inflammatory response in M→F group compared with other paired groups. The enhanced inflammatory response in M→F group may partially contribute to the high response of the MAP to the infusion of Ang II.…”

Section: Discussionmentioning

confidence: 99%

Role of Kidneys in Sex Differences in Angiotensin II–Induced Hypertension

Wang

et al. 2017

Hypertension

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The significance of kidneys in regulation of sodium and water balance and hemodynamics has been demonstrated both in patients and animal models. In the present study, we tested our hypothesis that kidneys play an essential role in control of sex differences in Ang II-dependent hypertension. Kidney transplantations (KTXs) were performed between male and female C57BL/6 mice (F, female; M, male; donor→recipient: F→F; M→M; F→M; and M→F). Radio-telemetry transmitters were implanted for measurement of mean arterial pressure (MAP) during the infusion of Ang II (600ng/kg/min). Gene expressions and inflammatory responses in the transplanted grafts were assessed. We found that same-sex-KTX mice still exhibited sex differences in Ang II-dependent hypertension (31.3±0.8 mmHg in M→M vs. 12.2±0.6 mmHg in F→F), which were reduced between M and F when they received kidneys of the opposite sex (32.9±1 mmHg in M→F vs. 22.3±0.7 mmHg in F→M). The sex differences in gene expressions, including AT1, AT1/AT2, ET1, ETA, NHE3, αENaC and γENaC, were unaltered in same-sex KTX and much lessened in cross-sex KTXs. In addition, the cross-sex KTXs exhibited more robust inflammatory responses reflected by higher expression of IL-6, TNFα, and KC than same-sex KTX. Our results indicate that kidneys play an essential role in sex differences of Ang II-dependent hypertension. KTX of male kidneys to females augmented the BP response while KTX of female kidneys to males attenuated the BP response. The host’s extra-renal systems modulate expressions of many genes and inflammatory response, which may also contribute to the sex differences in blood pressure regulation.

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Minor Histocompatibility Antigens as Risk Factor for Poor Prognosis in Kidney Transplantation

Cited by 14 publications

References 44 publications

Impact of donor–recipient sex match on long‐term survival after heart transplantation in children: An analysis of 5797 pediatric heart transplants

Impact of donor–recipient sex match on long‐term survival after heart transplantation in children: An analysis of 5797 pediatric heart transplants

Gender Differences in Kidney Transplantation – 10-Year Retrospective Study

Role of Kidneys in Sex Differences in Angiotensin II–Induced Hypertension

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