Consort flow diagram of the study.

<div>BackgroundHLA-DQ antibodies are the most prevalent de novo donor-specific antibodies (dnDSAs) after kidney transplantation (KT). The immunogenicity and impact of each HLA-DQ mismatch on graft outcomes can vary considerably.Methods&l...

وصف كامل

محفوظ في:

التفاصيل البيبلوغرافية
المؤلف الرئيسي:	Peenida Skulratanasak (13016235) (author)
مؤلفون آخرون:	Thidarat Luxsananun (21094505) (author), Nuttasith Larpparisuth (13016232) (author), Nalinee Premasathian (221591) (author), Attapong Vongwiwatana (13016238) (author)
منشور في:	2025
الموضوعات:	Medicine Genetics Biotechnology Immunology Developmental Biology Marine Biology Cancer Infectious Diseases Plant Biology Computational Biology individualized immunosuppression adjustment de novo donor 21 – 6 11 – 6 significantly higher incidence kidney allocation based tacrolimus immunosuppression (< medication nonadherence (< censored graft survival 5 – 12 dq9 mismatches exhibit kt dndsa surveillance late graft rejection 491 kt recipients xlink "> hla xlink "> late rejection graft survival kidney transplantation higher rates graft outcomes dq9 mismatch dq mismatches dndsa occurrence dndsa development younger (< underwent kt kt ). specific hla specific antibodies siriraj hospital received non median time log rank inferior death dq mismatch dq exhibited dq antibodies center employed 044 ), 031 ), 028 ). 009 ),
الوسوم:	إضافة وسم لا توجد وسوم, كن أول من يضع وسما على هذه التسجيلة!

الوصف
الملخص:	<div><p>Background</p><p>HLA-DQ antibodies are the most prevalent de novo donor-specific antibodies (dnDSAs) after kidney transplantation (KT). The immunogenicity and impact of each HLA-DQ mismatch on graft outcomes can vary considerably.</p><p>Methods</p><p>This retrospective cohort study investigated the prevalence and risk factors for dnDSA development in patients who underwent KT at Siriraj Hospital between 2006 and 2020 and had HLA-DQB1 mismatches. Our center employed a protocol for post-KT dnDSA surveillance. The impact of dnDSAs on late rejection and graft survival was evaluated.</p><p>Results</p><p>In our cohort of 491 KT recipients, 59 (12.02%) developed dnDSAs to HLA-DQB1 at a median time of 4.2 years after KT. The risk of dnDSA occurrence was significantly higher among recipients with HLA-DQ7 mismatch (HR: 2.8; 95% CI: 1.21–6.52; <i>P</i> = 0.017) and HLA-DQ9 mismatch (HR: 2.63; 95% CI: 1.11–6.27; <i>P</i> = 0.028). Recipients who developed dnDSAs were younger (<i>P</i> = 0.009), had higher rates of medication nonadherence (<i>P</i> = 0.031), had pre-KT panel reactive antibody levels above 20% (<i>P</i> = 0.044), and received non-tacrolimus immunosuppression (<i>P</i> < 0.001) compared to those without. Recipients who developed dnDSAs to HLA-DQ exhibited a significantly higher incidence of late graft rejection (HR: 7.76; 95% CI: 5–12.03; <i>P</i> < 0.0001) and inferior death-censored graft survival than those without dnDSAs (log rank <i>P</i> < 0.001).</p><p>Conclusion</p><p>The patients with HLA-DQ7 and HLA-DQ9 mismatches exhibit the highest risk of developing dnDSAs. Individualized immunosuppression adjustment and kidney allocation based on specific HLA-DQ mismatch may enhance long-term graft survival.</p></div>

Consort flow diagram of the study.

مواد مشابهة