PIRCHE-II Is Related to Graft Failure after Kidney Transplantation.
Клиническое исследованиеСтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Geneugelijk Kirsten, Niemann Matthias, Drylewicz Julia, van Zuilen Arjan D, Joosten Irma, Allebes Wil A, van der Meer Arnold, Hilbrands Luuk B, Baas Marije C, Hack C Erik, van Reekum Franka E, Verhaar Marianne C, Kamburova Elena G, Bots Michiel L, Seelen Marc A J, Sanders Jan Stephan, Hepkema Bouke G, Lambeck Annechien J, Bungener Laura B, Roozendaal Caroline, Tilanus Marcel G J, Vanderlocht Joris, Voorter Christien E, Wieten Lotte, van Duijnhoven Elly M, Gelens Mariëlle, Christiaans Maarten H L, van Ittersum Frans J, Nurmohamed Azam, Lardy Junior N M, Swelsen Wendy, van der Pant Karlijn A, van der Weerd Neelke C, Ten Berge Ineke J M, Bemelman Fréderike J, Hoitsma Andries, van der Boog Paul J M, de Fijter Johan W, Betjes Michiel G H, Heidt Sebastiaan, Roelen Dave L, Claas Frans H, Otten Henny G, Spierings Eric
Аннотация
Individual HLA mismatches may differentially impact graft survival after kidney transplantation. Therefore, there is a need for a reliable tool to define permissible HLA mismatches in kidney transplantation. We previously demonstrated that donor-derived Predicted Indirectly ReCognizable HLA Epitopes presented by recipient HLA class II (PIRCHE-II) play a role in de novo donor-specific HLA antibodies formation after kidney transplantation. In the present Dutch multi-center study, we evaluated the possible association between PIRCHE-II and kidney graft failure in 2,918 donor-recipient couples that were transplanted between 1995 and 2005. For these donors-recipients couples, PIRCHE-II numbers were related to graft survival in univariate and multivariable analyses. Adjusted for confounders, the natural logarithm of PIRCHE-II was associated with a higher risk for graft failure [hazard ratio (HR): 1.13, 95% CI: 1.04-1.23, p = 0.003]. When analyzing a subgroup of patients who had their first transplantation, the HR of graft failure for ln(PIRCHE-II) was higher compared with the overall cohort (HR: 1.22, 95% CI: 1.10-1.34, p < 0.001). PIRCHE-II demonstrated both early and late effects on graft failure in this subgroup. These data suggest that the PIRCHE-II may impact graft survival after kidney transplantation. Inclusion of PIRCHE-II in donor-selection criteria may eventually lead to an improved kidney graft survival.