BACKGROUND:Immunologic injury is a main pathogenesis of chronic rejection,and it is related to multiple immunological associated-gene polymorphism,in particular,transforming growth factor-β1 gene polymorphism.Recently,there are a lot of researching results of the relationship between TGF-β1 gene polymorphism and chronic rejection.OBJECTIVE:To study the relationship between TGF-β1 genotypes and the chronic renal allograft rejection in recipients and donors.DESIGN:Prospective case analysis.SETTING:Department of Urinary Surgery,Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA;General Organ Transplantation Center.PARTICWANTS:A total of 144 recipients and 65 out of 114 donors(another 30 cases did not have the blood preparation)were selected from Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from Jane 2000 to May 2001.The surgical program was approved by the local ethics committee.METHODS:The TGF-β1 genotypes were detected in 144 recipients before renal transplantation and 65 out of 114 donors by sequence-specific primer polymerase chain reaction.The follow-up lasted for 5 years in recipients after surgery to survey chronic renal allografi rejection;furthermore,the effects of genotypes of recipients,genotypes of donors,and the genotype combination on transplanted renal function were analyzed.MAIN OUTCOME MEASURES:(1)Inciderce of chronic renal allograft reiection in recipients and donors with difierent TGF-β1 genotypes;(2)incidence of chronic renal allograft rejection in recipients and donors with TGF-β1 genotype combination.RESULTS:(1)Incidence of chronic renal allograft rejection in recipients with high-secretory TGF-β1 genotype was significantly higher than that in those with moderate-secretory or low-secretory TGF-β1 genotypes(x2=10.091,P<0.01).There were no significant differences in chronic renal allograft rejection among donors with different TGF-β1 genotypes(x2=0.002,P>0.05).(2)Chronic renal allograft rejection occurred in the recipients with high-secretory TGF-β1 genotype,whose donors also had high-secretory TGF-β1 genotype,and the incidence of chronic renal allograft rejection was significantly higher than that in other recipients with TGF-β1 genotype combination(x2=4.352,P<0.05).While the incidence of chronic renal allograft rejection in the recipients with moderate-secretory and low-secretory TGF-β1 genotypes,whose donors also had moderate-secretory and low-secretory TGF-β1 genotypes was significantly lower than that in other recipients with TGF-β1 genotype combination (x2=4.134,P<0.05).CONCLUSION:The TGF-β1 gene polymorphism is detected in the recipients and donors before renal transplantation to benefit for along-term prognostic factor for chronic renal allograft ejection and an ideal genotype combination between recipients and donors.