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- Title
Impact of Degree of Human Leucocyte Antigen Mismatch on Live Donor Kidney Transplant Recipients.
- Authors
Alaskary, Mostafa Ibrahim; ElHendy, Yasser Abdelmoneim; Donia, Ahmed Farouk; Allam, Hala Mohamed
- Abstract
Background: The human leukocyte antigen (HLA) system plays a crucial role in the activation and function of the immune system. HLA mismatches may lead to activation of alloreactive T-cells and development of donor-specific HLA antibodies (DSA), thereby significantly impairing kidney graft survival. Methods: From March 1976 and August 2019, 2200 kidney transplant recipients were included, and were divided according to the degree of HLA mismatch into three groups. Results: Acute rejection episodes were more frequent in groups 2 and 3. Chronic rejection was revealed in group II, and III graft biopsies more than in group I. Incidence of post-transplant hypertension and diabetes mellitus was higher in group III. Median serum creatinine was more elevated in group III after 2, 3, 4, and 5 years' post-transplantation with subsequent lower creatinine clearance. The majority of patients were alive with functioning graft at last follow-up, especially in group I. More patients were alive with failed graft at the last follow-up in group III. On the other hand, the 5, 10, and 15 years of graft and patient survival showed statistically significant differences between the three groups with better survival for group I. Conclusions: The degree of mismatch affected the choice of the immunosuppressive regimen. Higher HLA mismatch was associated with a higher incidence of diabetes and hypertension and lower patient and graft survival.
- Subjects
KIDNEY transplantation; HLA histocompatibility antigens; LEUCOCYTES; GRAFT survival; OVERALL survival
- Publication
Zagazig University Medical Journal, 2023, Vol 29, p208
- ISSN
1110-1431
- Publication type
Article
- DOI
10.21608/ZUMJ.2021.73570.2204