Eplet mismatch analysis and allograft outcome across racially diverse groups in a pediatric transplant cohort: a single-center analysis.
HLA eplet mismatch load has been suggested as an improvement to HLA antigen mismatch determination for organ selection. Given that eplet mismatches are determined based on amino acid sequence difference among HLA alleles, and that the frequency of HLA alleles varies between racial groups, we investi...
| Publicado en: | Pediatric Nephrology Vol. 35; no. 1; pp. 83 - 95 |
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| Autores principales: | , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Jan2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=140271404&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 140271404 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: Jan2020 vid: 35 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 140271404 140271404 140271404 10.1007/s00467-019-04344-1 140271404 ppf: 83 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Eplet mismatch analysis and allograft outcome across racially diverse groups in a pediatric transplant cohort: a single-center analysis. aug: au: Philogene, Mary Carmelle Amin, Anita Zhou, Sheng Charnaya, Olga Vega, Renato Desai, Niraj Neu, Alicia M. Pruette, Cozumel S. affil: Department of Medicine, Johns Hopkins School of Medicine, 2041 E. Monument Street, 21205, Baltimore, MD, USA sug: subj: Allografts Transplant Recipients In Infancy and Childhood Ethnic Groups HLA Antigens Histocompatibility Human Poisson Distribution Regression Risk Assessment Kidney Transplantation In Infancy and Childhood Graft Rejection Transplantation Immunology Alleles Child Race Factors Child: 6-12 years ab: HLA eplet mismatch load has been suggested as an improvement to HLA antigen mismatch determination for organ selection. Given that eplet mismatches are determined based on amino acid sequence difference among HLA alleles, and that the frequency of HLA alleles varies between racial groups, we investigated the correlation between eplet mismatch load and allograft outcomes in 110 pediatric kidney transplant recipients who received their first organ from a donor of the same race (SRT) versus a donor of a different race (DRT). Adjusted modified Poisson regression was used to assess the interaction between eplet mismatch load and race mismatch and its effect on outcome. Caucasians and living donor recipients had lower eplet mismatched loads against their donors compared with non-Caucasian and deceased donor recipients. Overall, for the entire population, the risk of de novo HLA-DSA development was significantly increased with higher eplet loads (p < 0.001). Compared with the SRT group, the DRT group had higher eplet loads when compared with their donor, for HLA class I but not HLA class II molecules; however, there was no significant difference in the incidence of de novo HLA-DSA between the 2 groups. The risk of rejection increased significantly for DRT compared with SRT, only when class I eplet load was ≥ 70 (p = 0.04). Together this data show that eplet mismatch load analysis is an effective tool for alloimmune risk assessment. If considered for donor selection, acceptable eplet mismatch loads determined from studies in homogenous populations may restrict transplantation across racially diverse donor and patient groups with no evidence of poor outcome. Therefore, an acceptable eplet mismatch load threshold must consider the heterogeneity of the transplant population. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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