Effect of HLA Mismatch on Recurrence and Graft Loss in Living versus Deceased Kidney Transplant Recipients with IgA Nephropathy
Johns Hopkins School of Medicine, Baltimore, MD
Meeting: 2019 American Transplant Congress
Abstract number: B147
Keywords: Graft failure, HLA matching, Nephropathy, Recurrence
Session Information
Session Name: Poster Session B: Kidney Donor Selection / Management Issues
Session Type: Poster Session
Date: Sunday, June 2, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: A registry based study from Australia and New Zealand reported increased risk of recurrent IgA nephropathy (IgAN) in zero-HLA-mismatched living donor kidney transplant (LDKT) recipients, possibly due to HLA genetics or the role of decreased immunosuppression. We sought to investigate the effect of HLA-mismatch on recurrence and all-cause graft loss (ACGL) in LDKT versus deceased donor kidney transplant recipients (DDKT) who had IgAN using national registry data from the US.
*Methods: Using SRTR data 2005-2018, we compared recurrent IgAN and all-cause graft loss (ACGL) in 7905 HLA-mismatched vs. 809 zero-HLA-mismatched adult first-time IgAN LDKT and DDKT recipients using Cox regression, adjusting for recipient and donor characteristics.
*Results: Risk of recurrent IgAN was comparable for HLA-mismatched and zero-HLA mismatched LDKT (aHR= 0.71 1.06 1.58) and DDKT (aHR= 0.66 1.22 2.26) recipients (Figure 1). In LDKT recipients, compared to zero-HLA-mismatched non-recurrent IgAN, HLA-mismatched non-recurrent, zero-HLA-mismatched recurrent, HLA-mismatched recurrent IgAN were associated with about 1.7-fold (aHR= 1.17 1.76 2.66), 5.8-fold (aHR= 2.71 5.82 12.49) and 8.2-fold (aHR= 5.21 8.18 12.85) higher risk of ACGL. In DDKT recipients, compared to zero-HLA-mismatched non-recurrent IgAN, HLA-mismatched recurrent IgAN was associated with 6-fold (aHR= 4.24 6.04 8.61) higher risk of ACGL (Table).
*Conclusions: HLA-mismatch in LDKT and DDKT recipients are not associated with increased risk of IgAN recurrence. Close monitoring are warranted for HLA-mismatched recurrent IgAN irrespective of donor-type; in addition LDKT recipients with zero-HLA-mismatched recurrent IgAN and HLA-mismatched non-recurrent IgAN.
To cite this abstract in AMA style:
Ishaque T, Ammary FA, Jackson K, Segev DL, Massie AB. Effect of HLA Mismatch on Recurrence and Graft Loss in Living versus Deceased Kidney Transplant Recipients with IgA Nephropathy [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/effect-of-hla-mismatch-on-recurrence-and-graft-loss-in-living-versus-deceased-kidney-transplant-recipients-with-iga-nephropathy/. Accessed May 9, 2025.« Back to 2019 American Transplant Congress