Details

Autor(en) / Beteiligte

• Gratwohl, Alois, Prof
• Döhler, Bernd, PhD
• Stern, Martin, MD
• Opelz, Gerhard, Prof

Titel

H-Y as a minor histocompatibility antigen in kidney transplantation: a retrospective cohort study

Ist Teil von

• The Lancet (British edition), 2008-07, Vol.372 (9632), p.49-53

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2008

Quelle

MEDLINE

Beschreibungen/Notizen

• Summary Background In haematopoietic stem-cell transplantation, male recipients of female grafts have an increased risk of graft-versus-host disease and female recipients have both an increased risk of rejection of male grafts and of specific T-cell and antibody reactivity against H-Y encoded gene products. By contrast, in kidney transplantation, the role of H-Y as a minor histocompatibility antigen has been disputed. We aimed to investigate whether an immunological H-Y effect occurs in kidney transplantation. Methods We did a retrospective cohort study between 1985 and 2004 in 195 516 recipients of allografts from deceased donors. We used multivariate statistical methods to compare graft survival and death-censored graft survival rates for female and male donor kidneys in female and male recipients at 1 and 10 years. Findings Graft loss was more common with kidneys from female donors than with those from male donors (p<0·001) after both 1 and 10 years. Female recipients had a lower rate of graft failure between the end of the first year and the end of the tenth year (p<0·001). Compared with all other combinations of sex, transplantation of male donor kidneys into female recipients was associated with an increased risk of graft failure during the first year (hazard ratio [HR] 1·08, 95% CI 1·03–1·14, p=0·003; death censored HR 1·11, 1·04–1·19, p=0·003) and between 2 and 10 years (HR 1·06, 1·01–1·10, p=0·008; death censored HR 1·10, 1·05–1·16, p<0·001). Interpretation H-Y minor histocompatibility affects human kidney transplantation. Funding Swiss National Research Foundation; University of Heidelberg, Germany; European Leukemia Net.