Impact of HLA-A-B-DR matching in kidney transplantation: Graft and patient survival in 5-year experiences
- VernacularTitle:Бөөр шилжүүлэн суулгахад HLA-A-B-DR тохирооны нөлөө: Суулгац болон өвчтөний амьдрах чадварыг 5 жилээр үнэлэхэд
- Author:
Sarantsetseg J
1
;
Oyunbileg B
1
;
Odgerel D
1
;
Narandulam B
1
;
Batbaatar G
2
;
Munkhbat B
2
Author Information
1. The First Central Hospital of Mongolia, HLA laboratory
2. Mongolian National University of Medical Sciences
- Publication Type:Journal Article
- Keywords:
HLA-A-B-DR matching;
kidney graft survival
- From:
Health Laboratory
2019;9(1):5-11
- CountryMongolia
- Language:Mongolian
-
Abstract:
Background:Kidney transplantation has being performed in Mongolia since 2006. However
there is currently no published data available on long-term graft and patient survival.
Objective:Our aim was to assess the long-term graft and patient survival rate correlation with HLA-A-B-DR matching.
Methods:We retrospectively analyzed data from 70 adult kidney transplants performed at
our hospital from August 2006 through January 2014. The data was retrospectively collected
from patient files, including characteristics of the recipient and donor, post transplant features
and HLA-A-B-DR DNA based typing results. The Kaplan-Meier method was used to analyze
graft and patient survival.
Results:The mean patient follow-up period after kidney transplantation was 39,6±25.9
months, and the mean kidney graft follow-up period was 36.6±23.7 months for 70 cases.
Overall graft and patient survivals were 52 (74.3%) and 60 (85.7%) respectively in 70 cases.
Five-year graft and patient survivals were 23 (67.6%) and 29 (85.3%) respectively in 34
cases. The group with four to six mismatched were found to have a significantly lower 3 and
5-year graft and patient survival (71%; 35%); (80%; 40%) compared to 0 to 1 mismatched
group (100%) (p=.030; p=.015). Furthermore we analyzed the association of HLA matching,
immunosuppressive therapy and long-term graft survival. We selected CNI mono-therapy
group for long-term survival analysis and observed a similar pattern. In mono-therapy group,
the group with four to six mismatched were found to have a significantly lower 3 and 5-year
graft and patient survival (75%; 30%); (65%; 30%) compared to 0 to 1 mismatched group
(100%) (p=.037; p=.001).
Conclusion:The results showed that graft and patient survival rates were lower compared
with results from established centers. Statistically highly significant effect of HLA matching on
kidney graft and patient survival rates was found in our analysis. Five years after
transplantation the graft survival rate of first adult kidney transplant with 4-6MM was 65-70%
lower than that of grafts with 0-1MM. Longitudinal cohort study needed in the future to exhibit
an improved transplantation outcome.
- Full text:HL-2019-9(1)-5-11.pdf
