Risk Factors for Acute Rejection After Deceased Donor Kidney Transplantation in China

Fu, Qian; Zhang, H.; Nie, Weijian; Deng, Ronghai; Li, J.; Xiong, Ye; Dai, Yong; Liu, L.; Yuan, Xiaopeng; He, Xiaoshun; Wang, C.

doi:10.1016/j.transproceed.2018.03.063

Cited by 9 publications

(7 citation statements)

References 13 publications

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“…In our study, we could find an association of HLA-mismatch with graft rejection. Beside HLA-mismatch, our study confirmed positive pre-transplant PRA as a risk factor for acute rejection [42]. Since T-cell migration into the graft and their infiltration is essential for T-cell-mediated rejection and our study indicates that AQP3 expression is required for T-cell migration, blockade of AQP3 might depict a novel and promising therapeutic strategy to inhibit T-cell migration and could be a promising prophylactic therapy in transplantation.…”

Section: Discussionsupporting

confidence: 67%

The Aquaporin 3 Promoter Polymorphism −1431 A/G is Associated with Acute Graft Rejection and Cytomegalovirus Infection in Kidney Recipients Due to Altered Immune Cell Migration

Rump

Rahmel

Rustige

et al. 2020

Cells

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Major complications after kidney transplantation are graft rejection and cytomegalovirus (CMV) infection, which are related to T-cell function, which depends on aquaporin 3 (AQP3) expression. The impact of the AQP3 A(−1431)G promoter polymorphism in kidney transplant recipients was unelucidated and we explored the effect of AQP3 polymorphism on immune cell function and its association with graft rejection and CMV infection in 237 adult patients within 12 months after transplantation. AQP3 promoter polymorphism was molecular and functional characterized. Kaplan–Meier plots evaluated the relationship between genotypes and the incidence of CMV infection and graft rejection. AQP3 A(−1431)G A-allele was associated with enhanced immune cell migration and AQP3 expression in T-cells. The incidences of rejection were 45.4% for the A-allele and 27.1% for G-allele carriers (p = 0.005) and the A-allele was a strong risk factor (hazard ratio (HR): 1.95; 95% CI: 1.216 to 3.127; p = 0.006). The incidences for CMV infection were 21% for A-allele and 35% for G-allele carriers (p = 0.013) and G-allele was an independent risk factor (p = 0.023), with a doubled risk for CMV infection (HR: 1.9; 95% CI: 1.154 to 3.128; p = 0.012). Hence, A-allele confers more resistance against CMV infection, but susceptibility to graft rejection mediated by T-cells. Thus, AQP3-genotype adapted management of immunosuppression and antiviral prophylaxis after kidney transplantation seems prudent.

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Section: Discussionsupporting

confidence: 67%

The Aquaporin 3 Promoter Polymorphism −1431 A/G is Associated with Acute Graft Rejection and Cytomegalovirus Infection in Kidney Recipients Due to Altered Immune Cell Migration

Rump

Rahmel

Rustige

et al. 2020

Cells

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“…Also as expected, fewer HLA loci mismatches led to better postoperative kidney function in our study in the univariate analysis. This is consistent with earlier studies (20,33) and has great clinical value. It has also been reported that live-donor transplantation after desensitization provided a significant survival benefit for patients with HLA sensitization, as compared to waiting for a compatible organ (34).…”

Section: Discussionsupporting

confidence: 93%

“…Similarly, black kidney transplant recipients in the United Kingdom have increased risk of adverse graft-related outcomes owing to highrisk baseline variables (16). While in China there have been few studies analyzing factors of recipients and donors influencing kidney function after transplantation, and no comparisons among diverse ethnic groups (17)(18)(19)(20)(21). Therefore, it's high time to conduct corresponding research to provide references for kidney transplantation in China.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, it's high time to conduct corresponding research to provide references for kidney transplantation in China. Additionally, the sample size of each research study has been limited, ranging from 300 to 600 participants (18,20,22). However, kidney transplantation is affected by numerous factors, and a larger sample size is required to rule out confounding factors.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of Factors Influencing Kidney Function of Recipients After Renal Transplantation in Southwestern China: A Retrospective Study

Xin

Zhou

et al. 2020

Front. Med.

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“…Many studies have found that immunosuppressive medication non-adherence can lead to an increased risk of rejection (Belaiche et al, 2017;Leven et al, 2017). Of course, the occurrence of rejection is not just related to immunosuppressive medication non-adherence, and longer pre-transplant dialysis duration, HLA mismatch, and positive pretransplant PRA were also risk factors for acute rejection (Fu et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Association Between Regulatory Emotional Self-Efficacy and Immunosuppressive Medication Adherence in Renal Transplant Recipients:Does Medication Belief Act as a Mediator?

et al. 2021

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Background: Few studies have investigated the association between regulatory emotional self-efficacy (RESE) and immunosuppressive medication adherence or the mechanisms underlying this relationship. Considering that previous evidence of immunosuppressive medication adherence depended on the level of immunosuppressive medication beliefs, a model of multiple mediation was tested in which immunosuppressive medication beliefs acted as mediators of the relationship between RESE and immunosuppressive medication adherence.Methods: A retrospective cross-sectional study was performed in 293 renal transplant patients during outpatient follow-ups from November 2019 to February 2020 in China. All participants completed a general demographic questionnaire, the Chinese version of the RESE, the Beliefs about Medication Questionnaire, and the Basel Assessment of Adherence with Immunosuppressive Medication Scale (BAASIS). Spearson correlation analysis was carried out to identify the correlation between RESE and immunosuppressive medication adherence. Binary logistic regression analysis was performed to confirm factors associated with immunosuppressive medication adherence in renal transplant recipients. Mediating effect analysis was used to explore the internal interaction between RESE and immunosuppressive medication adherence.Results: A total of 293 renal transplant patients were recruited, including 111 women and 182 men with a mean age of 42.5 years (SD = 10.0). A total of 23.21% of patients exhibited immunosuppressive medication none-adherence behavior, and 12.97% reported altering the prescribed amount of immunosuppressive medication without physician permission, which was most popular behavior among patients. The mean RESE score was 45.78 ± 6.12; the positive (POS) score was the highest, and the anger-irritation (ANG) score was the lowest. The correlation analysis results showed that RESE (r = −0.642, p < 0.01) and immunosuppressive medication beliefs (r = −0.534, p < 0.01) were significantly associated with immunosuppressive medication adherence. Binary logistic regression analysis indicated that marital status, fertility status, rejection, immunosuppressive medication beliefs, and RESE were found to be independent predictors of immunosuppressive medication adherence [R2 = 0.803, p < 0.05]. The results of the mediating effect analysis showed that immunosuppressive medication necessity had a partial mediating effect, RESE directly and indirectly affected immunosuppressive medication adherence via immunosuppressive medication necessity, and immunosuppressive medication concerns were not a mediator between RESE and immunosuppressive medication adherence.Conclusion: The levels of immunosuppressive medication adherence in renal transplant patients need to be improved in China. Marital status, fertility status, rejection, immunosuppressive medication beliefs, and RESE were major factors affecting immunosuppressive medication adherence. RESE could affect immunosuppressive medication adherence indirectly through immunosuppressive medication necessity.

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Risk Factors for Acute Rejection After Deceased Donor Kidney Transplantation in China

Cited by 9 publications

References 13 publications

The Aquaporin 3 Promoter Polymorphism −1431 A/G is Associated with Acute Graft Rejection and Cytomegalovirus Infection in Kidney Recipients Due to Altered Immune Cell Migration

The Aquaporin 3 Promoter Polymorphism −1431 A/G is Associated with Acute Graft Rejection and Cytomegalovirus Infection in Kidney Recipients Due to Altered Immune Cell Migration

Analysis of Factors Influencing Kidney Function of Recipients After Renal Transplantation in Southwestern China: A Retrospective Study

Association Between Regulatory Emotional Self-Efficacy and Immunosuppressive Medication Adherence in Renal Transplant Recipients:Does Medication Belief Act as a Mediator?

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