The Privilege of Induction Avoidance and Calcineurin Inhibitors Withdrawal in 2 Haplotype HLA Matched White Kidney Transplantation

Brifkani, Zaid; Brennan, Daniel C.; Lentine, Krista L.; Horwedel, Timothy A.; Malone, Andrew F.; Santos, Rowena Delos; Maw, Thin Thin; Alhamad, Tarek

doi:10.1097/txd.0000000000000645

Cited by 3 publications

(1 citation statement)

References 24 publications

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“…According to the ndings of our study, the frequencies of most haplotypes between ESRD patients and controls did not differ signi cantly, suggesting it is relatively easy to nd a donor to match patients with those haplotypes [23]. [31]. For the long-term survival of renal transplantation patients, it would be crucial not to select the susceptible alleles and haplotypes in matched consanguineous donors [32].…”

Section: Discussionmentioning

confidence: 68%

Association between End-stage renal disease and the polymorphism of HLA in Guangxi Zhuang population

Pei,

Li,

Huang

et al. 2024

Preprint

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Objective: To investigate the genetic relationship between end-stage renal disease (ESRD) and the Guangxi Zhuang population's human leukocyte antigen (HLA) allele. Methods: To perform the polymerase chain reaction reversed sequence-specific oligonucleotide (PCR-rSSO)method, genotyping for 325 patients with ESRD at the HLA-A, B, C, DRB1, and DQB1 loci was done. The direct counting method was used to determine the HLA alleles' frequencies, and Arlequin software(3.5.2.2) was used for haplotypic frequency analyses, compared with 350 healthy donors of Guangxi Zhuang nationality. Results: We found that only HLA-DRB1*14:54 showed a positive association with ESRD (P=0.005, Pc=0.035, OR=1.484, CI=1.122-1.963) after Bonferroni correction, so that it may be a protective allele for ESRD. A*11:01-B*15:02-DRB1*15:01 and A*11:01-C*08:01-B*15:02-DRB1*12:02-DQB1*03:01 were more prevalent in ESRD after Bonferroni correction. Conclusion: ESRD patients and the healthy population in Guangxi Zhuang have high HLA-A, B, C, DRB1, and DQB1 allele and haplotype frequencies. DRB1*14:54, A*11:01-B*15:02-DRB1*15:01, and A*11:01-C*08:01-B*15:02-DRB1*12:02-DQB1*03:01 were potentially valuable allele and haplotypes for evaluating the risk of ESRD in Guangxi Zhuang population.

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Section: Discussionmentioning

confidence: 68%

Association between End-stage renal disease and the polymorphism of HLA in Guangxi Zhuang population

Pei,

Li,

Huang

et al. 2024

Preprint

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Immunosuppression and Graft Rejection in Living-related HLA-identical Renal Transplantation: The RADOVFULL Study

et al. 2020

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Background. We aimed to describe the immunosuppressive regimens and graft rejection rates in living-related HLA-identical (LR HLAid) renal transplantation. Methods. We performed a retrospective multicenter analysis of the French national database for LR HLAid renal transplantations performed between 2002 and 2012. Univariate and multivariate analysis were performed to determine risk factors for graft rejection in LR HLAid recipients. Results. A total of 27 218 renal transplantations were performed, of whom 163 had a LR HLAid donor. About immunosuppressive treatment, <60% of the cohort had induction therapy with polyclonal or monoclonal antibodies, 28% did not receive calcineurin inhibitors, and 36% did not receive steroids in maintenance. Biopsy-proven acute rejection was diagnosed in 21 patients (12.9%). Rejection occurred on an average of 24 months after transplantation, in 28.5% of the cases after minimization of immunosuppression. Factors associated with rejection were age of recipient (OR, 0.91 [0.84–0.96]; P = 0.003), the body mass index of donors (odds ratio [OR], 1.22 [1.04–1.46]; P = 0.01), and minimization of immunosuppression (OR, 26.2 [5.48–166.6]; P < 0.001). Overall and graft survival rates were not statistically different according to rejection at 1, 5, and 10 years posttransplantation. Conclusions. Minimization of immunosuppression should be done with caution in LR HLAid renal transplantations.

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Mycophenolate Monotherapy in HLA-Matched Kidney Transplant Recipients: A Case Series of 20 Patients

Hennes

Holdener

Burlingham

et al. 2020

Transplantation Direct

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Background. The ideal minimizing strategy for maintenance immunosuppression in HLA-matched kidney transplant recipients (KTR) is unknown. We hypothesized that mycophenolate (MPA) monotherapy is a safe and effective approach for maintenance therapy in this group of KTR. Methods. Data were abstracted for 6-antigen HLA-matched KTR between 1994 and 2013. Twenty recipients receiving MPA monotherapy secondary to infection, cancer, calcineurin inhibitor (CNI) side effects, or immunosuppression minimization strategies were evaluated in this case series. Results. MPA monotherapy had a low incidence of death-censored graft failure (3.19/100 person-y), rejection (0/100 person-y), hospitalization (1.62/100 person-y), malignancy (3.61/100 person-y), and infection (1.75/100 person-y). Further, 12-month mean or median serum creatinine (1.29 mg/dL), estimated glomerular filtration rate (64.3 mL/min/1.73 m2), urine protein creatinine ratio (143.2 mg/g), hemoglobin (13.9 g/dL), platelets (237.8 K/uL), and white blood cell count (9.04 K/uL) were favorable. There was a successful conversion rate of 90% (18 of 20) with 2 patients converting back to CNI-based regimens secondary to recurrence of membranous nephropathy and post-transplant lymphoproliferative disorder. Conclusions. Our findings indicate that MPA monotherapy may be a promising immunosuppression minimization strategy for HLA-matched KTR.

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The Privilege of Induction Avoidance and Calcineurin Inhibitors Withdrawal in 2 Haplotype HLA Matched White Kidney Transplantation

Cited by 3 publications

References 24 publications

Association between End-stage renal disease and the polymorphism of HLA in Guangxi Zhuang population

Association between End-stage renal disease and the polymorphism of HLA in Guangxi Zhuang population

Immunosuppression and Graft Rejection in Living-related HLA-identical Renal Transplantation: The RADOVFULL Study

Mycophenolate Monotherapy in HLA-Matched Kidney Transplant Recipients: A Case Series of 20 Patients

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