Long- and short-term outcomes in renal allografts with deceased donors: a large recipient and donor genome-wide association study
Improvements in immunosuppression have modified short-term survival of deceased-donor allografts, but not their rate of long-term failure. Mismatches between donor and recipient HLA play an important role in the acute and chronic allogeneic immune response against the graft. Perfect matching at clin...
Gespeichert in:
| Hauptverfasser: | , |
|---|---|
| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
2018
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| In: |
American journal of transplantation
Year: 2018, Jahrgang: 18, Heft: 6, Pages: 1370-1379 |
| ISSN: | 1600-6143 |
| DOI: | 10.1111/ajt.14594 |
| Online-Zugang: | Verlag, Volltext: https://doi.org/10.1111/ajt.14594 Verlag, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/ajt.14594 
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| Verfasserangaben: | Maria P. Hernandez‐Fuentes, Christopher Franklin, Irene Rebollo‐Mesa, Jennifer Mollon, Florence Delaney, Esperanza Perucha, Caragh Stapleton, Richard Borrows, Catherine Byrne, Gianpiero Cavalleri, Brendan Clarke, Menna Clatworthy, John Feehally, Susan Fuggle, Sarah A. Gagliano, Sian Griffin, Abdul Hammad, Robert Higgins, Alan Jardine, Mary Keogan, Timothy Leach, Iain MacPhee, Patrick B. Mark, James Marsh, Peter Maxwell, William McKane, Adam McLean, Charles Newstead, Titus Augustine, Paul Phelan, Steve Powis, Peter Rowe, Neil Sheerin, Ellen Solomon, Henry Stephens, Raj Thuraisingham, Richard Trembath, Peter Topham, Robert Vaughan, Steven H. Sacks, Peter Conlon, Gerhard Opelz, Nicole Soranzo, Michael E. Weale, Graham M. Lord |
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| 520 | |a Improvements in immunosuppression have modified short-term survival of deceased-donor allografts, but not their rate of long-term failure. Mismatches between donor and recipient HLA play an important role in the acute and chronic allogeneic immune response against the graft. Perfect matching at clinically relevant HLA loci does not obviate the need for immunosuppression, suggesting that additional genetic variation plays a critical role in both short- and long-term graft outcomes. By combining patient data and samples from supranational cohorts across the United Kingdom and European Union, we performed the first large-scale genome-wide association study analyzing both donor and recipient DNA in 2094 complete renal transplant-pairs with replication in 5866 complete pairs. We studied deceased-donor grafts allocated on the basis of preferential HLA matching, which provided some control for HLA genetic effects. No strong donor or recipient genetic effects contributing to long- or short-term allograft survival were found outside the HLA region. We discuss the implications for future research and clinical application. | ||
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| 650 | 4 | |a Kidney transplantation/nephrology | |
| 650 | 4 | |a Rejection | |
| 650 | 4 | |a Translational research/science | |
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