ABSTRACT
BACKGROUND AND OBJECTIVES: HLA matching at the A, B, and DR loci influences the graft survival rate of deceased donor kidney transplants. The effect of HLA-DQB1 matching on transplant outcomes is still controversial. The aim of this study was to investigate the association of HLA-DQB1 matching with allograft outcomes in deceased donor kidney transplant recipients. METHODS: A retrospective analysis of deceased donor kidney transplant recipients between 2008 and 2014 at the Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand, was performed. Donor-recipient HLA matching at DQB1 locus was analyzed. The association between HLA-DQB1 mismatches and transplant outcomes was investigated using adjusted Cox regression analysis. RESULTS: A total of 383 deceased donor kidney transplants were performed during the study period, of which 297 with complete clinical and laboratory data were analyzed. The median follow-up time of all patients was 41 months (range, 16.4-65.6 months). Of the 297 recipients, 107 (36.03%) received 0 HLA-DQB1 mismatched kidneys and 190 (63.97%) received 1 or 2 HLA-DQB1 mismatched kidneys. Recipients who have received 1 or 2 HLA-DQB1 mismatched kidneys had a higher risk of acute rejection, with the adjusted hazard ratio of 4.35 (95% CI, 1.41-13.42; P = .01). However, HLA-DQB1 mismatching was not associated with chronic rejection and graft survival. CONCLUSION: Donor-recipient HLA-DQB1 mismatching is associated with acute rejection in deceased donor kidney transplants. However HLA-DQB1 mismatching does not have a negative impact on chronic rejection or graft survival.
Subject(s)
Graft Rejection/immunology , Graft Survival/immunology , HLA-DQ beta-Chains/immunology , Histocompatibility Testing , Kidney Transplantation/methods , Adolescent , Adult , Allografts , Female , Humans , Male , Middle Aged , Retrospective Studies , Thailand , Tissue Donors , Transplantation, HomologousABSTRACT
BACKGROUND: Dual kidney transplants (DKTs) from expanded criteria donors (ECDs) have been performed in our hospital since 2014. We needed to review our clinical outcome and update criteria to selected ECDs for DKTs. MATERIALS AND METHODS: Between January 2014 and December 2016, 4 DKTs and 269 deceased donor kidney transplants were performed. The outcome of DKTs was reviewed. The literature was reviewed for surgical technique and indication for DKT. RESULTS: Four DKTs were performed between 2014 and 2016. One-year graft survival rate was 100%. One patient developed delayed graft function. No morbidity or mortality occurred. CONCLUSIONS: DKTs in our center were safe and had good outcome with optimized selected criteria. DKT can improve the rate of kidney transplant in a developing country.
