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Maternal compared with paternal donor kidneys are associated with poorer graft outcomes after kidney transplantation. | LitMetric

Maternal compared with paternal donor kidneys are associated with poorer graft outcomes after kidney transplantation.

Kidney Int

Australia and New Zealand Dialysis and Transplant Registry, South Australia, Australia; Centre for Transplant and Renal Research, Westmead Hospital, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, New South Wales, Australia; Sydney School of Public Health, University of Sydney, New South Wales, Australia.

Published: March 2016

AI Article Synopsis

  • Noninherited maternal human leukocyte antigens in kidney transplants may negatively impact outcomes more than paternal antigens, particularly in the context of modern immunosuppression.
  • A study analyzing kidney transplant data from Australia and New Zealand (1997-2012) found that recipients of maternal donor kidneys had a 54% higher risk of acute rejection compared to those receiving paternal donor kidneys.
  • The increased risk of graft loss was primarily observed in recipients who experienced acute rejection, indicating that the choice of parental donor is crucial and should be carefully considered by clinicians and patients.

Article Abstract

Noninherited maternal human leukocyte antigens may be less detrimental on allograft outcomes after kidney transplantation compared with noninherited paternal antigens, but this association in the era of modern immunosuppression remains unknown. Here we determine the association between parental donor kidneys, acute rejection, and graft failure in primary live-donor parental kidney transplant recipients using data from the Australia and New Zealand Dialysis and Transplant Registry between 1997 and 2012. Of the 1139 recipients followed for a median of 7.2 years (8588 person-years), 652 received kidneys from maternal donors. Compared with paternal donor kidneys, maternal donor kidneys were associated with a significantly increased risk of acute rejection (adjusted odds ratio 1.54; 95% confidence interval [CI], 1.14-2.07) and significant overall graft loss. The latter was confined to recipients who have experienced acute rejection (adjusted hazard ratio 1.60; 95%CI, 1.05-2.43) but not in those who did not experience acute rejection. Thus, our study suggests that recipients of maternal donor kidneys have a greater risk of rejection and graft loss. Hence, clinicians and patients should be cognizant of this association when determining which of the 2 parental donors is most suitable for transplantation.

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Source
http://dx.doi.org/10.1016/j.kint.2015.11.016DOI Listing

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