Abstract: TH-PO999

Effect of Human Leukocyte Antigen Mismatching on the Outcomes of Kidney Transplantation: A Systematic Review and Meta-Analysis

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Shi, Xinmiao, Peking University First Hospital, Beijing, China
  • Liu, Rui, The First Hospital of Tsinghua University, Beiijng, China
  • Lv, Jicheng, Renal Division, Peking University First Hospital, Beijing, China
  • Xie, Xinfang, Renal Division, Peking University First Hospital, Beijing, China
  • Zhong, Xuhui, Peking University First Hospital, Beijing, China
  • Ding, Jie, Peking University First Hospital, Beijing, China
Background

The impact of HLA mismatching on kidney transplantation(KT) remains controversial.We aimed to evaluate the effect of HLA mismatching on KT.

Methods

We systematically searched PubMed,EMBASE,and the Cochrane Library for relevant studies.

Results

For adults,every HLA mismatch(mm) increase was associated with increased risk of overall graft failure (HR=1.06;95%CI,1.05-1.07), death-censored graft failure (HR=1.09;95%CI,1.06-1.11) and mortality (HR=1.05;95%CI,1.02-1.07).Moreover,HLA-DR mismatching was associated with significantly inferior graft survival(HR=1.08; 95%CI,1.05-1.11),but not HLA-A (HR=1.06;95% CI,0.98-1.14) or HLA-B (HR=1.01;95%CI,0.89-1.14).For children, compared with 0–1 HLA-DR mm,2 mm significantly increased the risk of graft failure at 1 year (RR=1.41,95%CI:1.11–1.80),3 years (RR=1.28,95%CI:1.08–1.52),5 years(RR=1.21,95%CI:1.04–1.41),and 10 years (RR=1.30,95%CI:1.02–1.67).For HLA-A+B,the 5-year graft failure risk was higher for 2–4 compared with 0–1 mm (RR=3.17,95%CI:1.20–8.36),but not for 3–4 compared with 0–2 mm (RR=1.49,95%CI:0.79–2.80).

Conclusion

For adults,HLA mismatching is an independent factor affecting graft failure and mortality.HLA-DR appears to be more essential than HLA-A or -B. For children,HLA-DR and HLA-A+B are important factors affecting graft failure.

Funding

  • Government Support - Non-U.S.