Q Fu1, H Zhang1, W Nie1, R Deng1, J Li1, Y Xiong1, Y Dai2, L Liu1, X Yuan3, X He4, C Wang5. 1. Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. 2. Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China. 3. Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. Electronic address: rocyuan@yeah.net. 4. Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory for Organ Donation and Transplant Immunology, Guangzhou, China. 5. Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory for Organ Donation and Transplant Immunology, Guangzhou, China. Electronic address: wangchx@mail.sysu.edu.cn.
Abstract
OBJECTIVES: This study aimed to identify the potential risk factors of acute rejection after deceased donor kidney transplantation in China. METHODS: Adult kidney transplantations from deceased donors in our center from February 2004 to December 2015 were enrolled for retrospective analysis. All deceased donations complied with China's Organ Donation Program. No organs from executed prisoners were used. The incidence of clinical and biopsy-proved acute rejection was assessed with the Kaplan-Meier method, and the Cox proportional hazard model was used for multivariate analysis. RESULTS: One-year, 2-year, 3-year and 5-year incidences of acute rejection were 12.4%, 14.2%, 14.8%, and 17.1%, respectively. Multivariate analysis demonstrated that longer pre-transplant dialysis duration (hazard ratio [HR] 1.009 per month; 95% confidence interval, 1.003-1.015; P = .003), positive pre-transplant panel reactive antibody (PRA) (positive vs negative HR 3.266; 1.570-6.793; P = .023), and increasing HLA mismatches (≥4 vs < 4 HR 2.136; 1.022-4.465; P = .044) increased the risk of acute rejection, while tacrolimus decreased acute rejection risk compared to cyclosporine (HR 0.317; 0.111-0.906; P = .032). CONCLUSION: Longer pre-transplant dialysis duration, HLA mismatch, and positive pre-transplant PRA increase the risk of acute rejection, while tacrolimus helps prevent acute rejection compared to cyclosporine in deceased donor kidney transplantation.
OBJECTIVES: This study aimed to identify the potential risk factors of acute rejection after deceased donor kidney transplantation in China. METHODS: Adult kidney transplantations from deceased donors in our center from February 2004 to December 2015 were enrolled for retrospective analysis. All deceased donations complied with China's Organ Donation Program. No organs from executed prisoners were used. The incidence of clinical and biopsy-proved acute rejection was assessed with the Kaplan-Meier method, and the Cox proportional hazard model was used for multivariate analysis. RESULTS: One-year, 2-year, 3-year and 5-year incidences of acute rejection were 12.4%, 14.2%, 14.8%, and 17.1%, respectively. Multivariate analysis demonstrated that longer pre-transplant dialysis duration (hazard ratio [HR] 1.009 per month; 95% confidence interval, 1.003-1.015; P = .003), positive pre-transplant panel reactive antibody (PRA) (positive vs negative HR 3.266; 1.570-6.793; P = .023), and increasing HLA mismatches (≥4 vs < 4 HR 2.136; 1.022-4.465; P = .044) increased the risk of acute rejection, while tacrolimus decreased acute rejection risk compared to cyclosporine (HR 0.317; 0.111-0.906; P = .032). CONCLUSION: Longer pre-transplant dialysis duration, HLA mismatch, and positive pre-transplant PRA increase the risk of acute rejection, while tacrolimus helps prevent acute rejection compared to cyclosporine in deceased donor kidney transplantation.
Authors: Katharina Rump; Tim Rahmel; Anna-Maria Rustige; Matthias Unterberg; Hartmuth Nowak; Björn Koos; Peter Schenker; Richard Viebahn; Michael Adamzik; Lars Bergmann Journal: Cells Date: 2020-06-08 Impact factor: 6.600
Authors: Zhaodan Xin; Lijuan Wu; Juan Zhou; Jie Zhuang; Wu Peng; Turun Song; Tao Lin; Xiaojun Lu; Binwu Ying Journal: Front Med (Lausanne) Date: 2020-11-12