Development of posttransplant antidonor HLA antibodies is associated with acute humoral rejection and early graft dysfunction.

Background: The goal of this study was to determine whether the production of posttransplant antibodies directed against donor HLA mismatches (donor specific antibody; DSA) is associated with renal allograft rejection and early graft dysfunction.

Methods: Forty-nine adult renal allograft recipients with increased risk of rejection were enrolled during the period of October 2001 through May 2003 and were prospectively monitored for the development of anti-HLA antibodies.

Results: Of 49 patients, eight (16.

HLA matching in the new millennium.

Despite increasing graft survival rates associated with advances in immunosuppression, the relative risk of graft loss for transplants with HLA mismatches has remained at about 25% higher than those with 0 ABDR-mismatches. The percentage of 0 DR-mismatched transplants peaked at 25% in 1994 and has decreased yearly to 15% in 2003. The percentage of transplants with a flow crossmatch increased from 5% in 1988 to 38% in 2003.

Look-up survival tables for living-donor renal transplants: OPTN/UNOS data 1995-2002.

1. We have provided reference tables of living-donor kidney graft survival rates based on data reported to the OPTN/UNOS Registry between 1995-2002. Graft survival rates from 28,860 living-related (LRD) and 8,444 living-unrelated donor (LUD) kidneys were 6 and 4 percentage points higher, respectively, at one year after-transplantation compared to the rate for deceased donor kidneys (70,801 DD grafts with GS = 89%).

The OPTN/UNOS Renal Transplant Registry 2003.

The number of living donor kidney transplants reported to the OPTN/UNOS Registry more than doubled during the decade from 1992-2002, from 2,535 to 6,236, with the largest increases in transplants from offspring to their parents and from spouses and other genetically unrelated donors. Despite the rise in more HLA-incompatible living donors, 5-year graft survival rates among recipients transplanted between 1998-2002 were 78.5% and 77.

HLA class I signal transduction is dependent on Rho GTPase and ROK.

Chronic rejection is the major limitation to long-term allograft survival. HLA class I signaling pathways have been implicated in this process because ligation of class I molecules by anti-HLA antibodies (Ab) initiates intracellular signals in smooth muscle cells (SMC) and endothelial cells (EC) that synergize with growth factor receptors to elicit cell survival and proliferation. Anti-HLA Ab mediate cell proliferation and survival through a focal adhesion kinase dependent pathway that requires the integrity of the actin cytoskeleton.

A multi-factor analysis of kidney regraft outcomes.

1. GENERAL: We updated prior analyses of renal retransplants reported to the UNOS Registry by estimating the compound effects of 22 covariates on regraft survival within 2 consecutive posttransplant risk periods. During an early risk period, 9,126 kidney-only regraft recipients were followed through one year, and, in a second risk period, 7,798 recipients whose regrafts survived beyond one year were followed for 5 years posttransplant.

The UNOS Renal Transplant Registry.

Based upon data reported to the UNOS Renal Transplant Registry between 1998-2001, the overall one- and projected 10-year graft survival rates for 31,720 cadaveric kidney transplants were 89% and 51%, and for 14,162 living donor transplants they were 95% and 68%, respectively. These results represent improvements of 15% and 13%, respectively, over the 10-year graft survival rates reported for transplants performed during 1987-1989. Repeat kidney transplants accounted for 14% of deceased donor kidney transplants during 1998-2001 and the 3-year graft survival rates were significantly lower for second (77%) and multiply regrafted (73%) than for recipients of a first transplant (79%; p < 0.

Signal transduction via MHC class I molecules in endothelial and smooth muscle cells.

MHC class I molecules have long been recognized for their ability to stimulate intracellular signals in T and B lymphocytes. More recently, it has become clear that MHC class I molecules can also initiate intracellular signals in endothelial and smooth muscle cells, which synergize with growth factor receptors to elicit cell proliferation. This review describes our current knowledge of class I-mediated signaling pathways in human endothelial and smooth muscle cells.

Strong associations between specific HLA-DQ and HLA-DR alleles and the tubulointerstitial nephritis and uveitis syndrome.

Purpose: To identify genetic markers for the tubulointerstitial nephritis and uveitis (TINU) syndrome by using human leukocyte antigen (HLA) genotyping.

Methods: Eighteen patients who had TINU syndrome were evaluated at three institutions. Typing of class I and II genes was performed by using DNA-based techniques.

The UNOS renal transplant registry.

The shortage of cadaver kidneys relative to increasing demand for transplantation has lead to a remarkable rise in transplantation from living donors. Based upon data reported to UNOS, the number of living donor kidneys transplanted in 2000 (5,106) nearly equaled the number of cadaver kidneys from preferred donors aged 6-50. HLA-mismatched siblings, offspring, spouses and other genetically unrelated donors accounted for nearly 80% of increased living donor transplantation during 1994-2000.

Living unrelated donor kidney transplantation.

Background: Living unrelated donors remain an underutilized resource, despite their high graft survival rates. In this article, we updated the long-term results of more than 2500 living unrelated donor transplants performed in the United States.

Methods: Between 1987 and 1998, 1765 spouse, 986 living unrelated, 27,535 living related, and 86,953 cadaver donor grafts were reported to the United Network for Organ Sharing Kidney Registry.