Association of mismatches for HLA-DR with incidence of posttransplant hip fracture in kidney transplant recipients
Background. - Bone fractures are a frequent complication after kidney transplantation, for which various predisposing factors have been identified. It has been suggested that human leukocyte antigen (HLA) mismatch increases the risk. - Methods. - Data on hip fractures occur...
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| Main Authors: | , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2011
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| In: |
Transplantation
Year: 2011, Volume: 91, Issue: 1, Pages: 65-69 |
| ISSN: | 1534-6080 |
| DOI: | 10.1097/TP.0b013e3181fa94d6 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1097/TP.0b013e3181fa94d6 Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/transplantjournal/Fulltext/2011/01150/Association_of_Mismatches_for_HLA_DR_With.11.aspx 
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| Author Notes: | Gerhard Opelz and Bernd Döhler |
| Summary: | Background. - Bone fractures are a frequent complication after kidney transplantation, for which various predisposing factors have been identified. It has been suggested that human leukocyte antigen (HLA) mismatch increases the risk. - Methods. - Data on hip fractures occurring in the first 5 years posttransplant were analyzed among kidney transplants from deceased donors performed between 1995 and 2008 and reported to the Collaborative Transplant Study. - Results. - In the 20,509 patients analyzed, the cumulative rate of hip fracture by year 5 posttransplant was 0.85%. Cox regression analysis identified the following risk factors: female recipients aged 40 to 59 years (hazard ratio [HR] 2.26, P=0.029), female recipients 60 years or older (HR 5.14, P<0.001), male recipients 60 years or older (HR 2.39, P=0.028), and donor age more than or equal to 60 years (HR 1.75, P=0.009). Using the rate of fractures in recipients with zero HLA-DR mismatch as the reference, the risk of hip fracture increased for grafts with one HLA-DR mismatch to HR 1.85 (95% confidence interval [CI] 1.18-2.89, P=0.007) and with two HLA-DR mismatches to HR 2.24 (CI 1.25-4.02, P=0.007). There was a significant association between the number of HLA-DR mismatches and the diagnosis of osteoporosis 5 years after transplantation: one HLA-DR mismatch risk ratio 1.26 (CI 1.12-1.43, P<0.001) and two HLA-DR mismatches risk ratio 1.45 (CI 1.20-1.74, P<0.001). - Conclusion. - The risk of hip fracture after kidney transplantation seems to be markedly exacerbated by HLA-DR mismatching. These findings add to the growing base of evidence that HLA-DR matching influences morbidity after kidney transplantation. |
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| Item Description: | Gesehen am 12.10.2022 |
| Physical Description: | Online Resource |
| ISSN: | 1534-6080 |
| DOI: | 10.1097/TP.0b013e3181fa94d6 |