Skip to main content
NCBI home page
The BMJ logoLink to The BMJ
. 1988 Oct 8;297(6653):888–890. doi: 10.1136/bmj.297.6653.888

Treatment with cyclosporin and risks of graft rejection in male kidney and heart transplant recipients with non-O blood.

G F Hendriks 1, E P van Steenberge 1, G M Schreuder 1, G J Wenting 1, B Mochtar 1, E Bos 1, M L Simoons 1, A H Balk 1, K Laird-Meeter 1, C E Essed 1, et al.
PMCID: PMC1834453  PMID: 3140966

Abstract

In a consecutive series of 146 kidney transplant recipients treated with cyclosporin A a strong correlation between matching for the HLA-A, HLA-B, and HLA-DR loci specificities and outcome of the grafts was observed in male recipients with non-O blood groups. Such a beneficial effect of matching was not found in female patients or male patients with blood group O. In these patients survival of the grafts at one year was good irrespective of the number of HLA-A, B, and DR mismatches. Also in 47 male heart transplant recipients immune responsiveness against mismatched HLA antigens was related to blood group. A significantly higher incidence of rejection episodes was observed in male patients with non-O blood groups (n = 32) than in those with blood group O (n = 15). Matching for HLA-DR reduced the number of acute rejection episodes in male patients with non-O blood. These findings may help explain the controversial reports about the importance of HLA matching in organ transplantation. Furthermore, as most candidates for heart transplantation are male and not of blood group O, the higher incidence of graft rejection in these patients underscores the need for an exchange strategy of donor hearts.

Full text

PDF
888

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Calne R. Y., White D. J., Thiru S., Evans D. B., McMaster P., Dunn D. C., Craddock G. N., Pentlow B. D., Rolles K. Cyclosporin A in patients receiving renal allografts from cadaver donors. Lancet. 1978 Dec 23;2(8104-5):1323–1327. doi: 10.1016/s0140-6736(78)91970-0. [DOI] [PubMed] [Google Scholar]
  2. Festenstein H., Doyle P., Holmes J. Long-term follow-up in London Transplant Group recipients of cadaver renal allografts. The influence of HLA matching on transplant outcome. N Engl J Med. 1986 Jan 2;314(1):7–14. doi: 10.1056/NEJM198601023140102. [DOI] [PubMed] [Google Scholar]
  3. Frist W. H., Oyer P. E., Baldwin J. C., Stinson E. B., Shumway N. E. HLA compatibility and cardiac transplant recipient survival. Ann Thorac Surg. 1987 Sep;44(3):242–246. doi: 10.1016/s0003-4975(10)62062-0. [DOI] [PubMed] [Google Scholar]
  4. Gorski J., Tilanus M., Giphart M., Mach B. Oligonucleotide genotyping shows that alleles at the HLA-DR beta III locus of the DRw52 supertypic group segregate independently of known DR or Dw specificities. Immunogenetics. 1987;25(2):79–83. doi: 10.1007/BF00364271. [DOI] [PubMed] [Google Scholar]
  5. Goulmy E., Persijn G. G., Blokland E., van Rood J. J. CML nonreactivity after kidney transplantation. Transplant Proc. 1981 Sep;13(3):1607–1609. [PubMed] [Google Scholar]
  6. Hendriks G. F., de Lange P., D'Amaro J., Schreuder G. M., Claas F. H., Persijn G. G., van Rood J. J. Eurotransplant experience with highly immunized patients. Scand J Urol Nephrol Suppl. 1985;92:81–86. [PubMed] [Google Scholar]
  7. Joysey V. C., Roger J. H., Evans D. B., Herbertson B. M. Differential kidney graft survival associated with interaction between recipient ABO group and pretransplant blood transfusion. Transplantation. 1977 Nov;24(5):371–376. doi: 10.1097/00007890-197711000-00009. [DOI] [PubMed] [Google Scholar]
  8. Joysey V. C., Roger J. H., Evans D. B., Herbertson B. M. Kidney graft survival and matching for HL-A and ABO antigens. Nature. 1973 Nov 16;246(5429):163–165. doi: 10.1038/246163a0. [DOI] [PubMed] [Google Scholar]
  9. McKenzie F. N., Tadros N., Stiller C., Keown P., Sinclair N., Kostuk W. Influence of donor-recipient lymphocyte crossmatch and ABO status on rejection risk in cardiac transplantation. Transplant Proc. 1987 Aug;19(4):3439–3441. [PubMed] [Google Scholar]
  10. Moen T., Albrechtsen D., Flatmark A., Jakobsen A., Jervell J., Halvorsen S., Solheim B. G., Thorsby E. Importance of HLA-DR matching in cadaveric renal transplantation: a prospective one-center study of 170 transplants. N Engl J Med. 1980 Oct 9;303(15):850–854. doi: 10.1056/NEJM198010093031504. [DOI] [PubMed] [Google Scholar]
  11. Opelz G., Terasaki P. I. Improvement of kidney-graft survival with increased numbers of blood transfusions. N Engl J Med. 1978 Oct 12;299(15):799–803. doi: 10.1056/NEJM197810122991503. [DOI] [PubMed] [Google Scholar]
  12. Opelz G., Terasaki P. I. Influence of sex on histocompatibility matching in renal transplantation. Lancet. 1977 Aug 27;2(8035):419–421. doi: 10.1016/s0140-6736(77)90606-7. [DOI] [PubMed] [Google Scholar]
  13. Persijn G. G., Gabb B. W., van Leeuwen A., Nagtegaal A., Hoogeboom J., van Rood J. J. Matching for HLA antigens of A, B, and DR loci in renal transplantation by Eurotransplant. Lancet. 1978 Jun 17;1(8077):1278–1281. doi: 10.1016/s0140-6736(78)91266-7. [DOI] [PubMed] [Google Scholar]
  14. Peto R., Pike M. C., Armitage P., Breslow N. E., Cox D. R., Howard S. V., Mantel N., McPherson K., Peto J., Smith P. G. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples. Br J Cancer. 1977 Jan;35(1):1–39. doi: 10.1038/bjc.1977.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Pfeffer P. F., Foerster A., Frøysaker T., Thorsby E. Correlation between HLA-DR mismatch and rejection episodes in cardiac transplantation. Transplant Proc. 1987 Feb;19(1 Pt 1):691–692. [PubMed] [Google Scholar]
  16. Raffoux C., Mayor V., Cabrol C., Busson M., Hors J., Colombani J. The influence of HLA matching in cardiac allograft recipients in a single center. Transplant Proc. 1987 Oct;19(5):3559–3560. [PubMed] [Google Scholar]
  17. Saiki R. K., Bugawan T. L., Horn G. T., Mullis K. B., Erlich H. A. Analysis of enzymatically amplified beta-globin and HLA-DQ alpha DNA with allele-specific oligonucleotide probes. Nature. 1986 Nov 13;324(6093):163–166. doi: 10.1038/324163a0. [DOI] [PubMed] [Google Scholar]
  18. Schreuder G. M., Hendriks G. F., D'Amaro J., Persijn G. G. An eight-year study of HLA typing proficiency in Eurotransplant. Tissue Antigens. 1986 Mar;27(3):131–141. doi: 10.1111/j.1399-0039.1986.tb01512.x. [DOI] [PubMed] [Google Scholar]
  19. Tilanus M. G., van Eggermond M. C., van der Bijl M., Morolli B., Schreuder G. M., De Vries R. R., Giphart M. J. HLA class II DNA analysis by RFLP reveals novel class II polymorphism. Hum Immunol. 1987 Apr;18(4):265–276. doi: 10.1016/0198-8859(87)90074-7. [DOI] [PubMed] [Google Scholar]
  20. Ting A., Morris P. J. Powerful effect of HL-DR matching on survival of cadaveric renal allografts. Lancet. 1980 Aug 9;2(8189):282–285. doi: 10.1016/s0140-6736(80)90234-2. [DOI] [PubMed] [Google Scholar]
  21. Vanrenterghem Y., Vandeputte I., Lerut T., Roels L., Gruwez J., Michielsen P. Importance of HLA-DR matching in polytransfused cadaveric kidney transplant recipients. A prospective one-center study. Transplantation. 1983 Oct;36(4):384–387. doi: 10.1097/00007890-198310000-00007. [DOI] [PubMed] [Google Scholar]
  22. Weimar W., Hendriks G. F., Wenting G. J., Vincent H. H., Schreuder G. M., Jeekel J. Prophylactic antilymphocyte globulin and HLA-DR matching reduce the incidence of rejection after cadaveric kidney transplantation. Transplant Proc. 1987 Oct;19(5):3612–3613. [PubMed] [Google Scholar]
  23. Yacoub M., Festenstein H., Doyle P., Martin M., McCloskey D., Awad J., Gamba A., Khaghani A., Holmes J. The influence of HLA matching in cardiac allograft recipients receiving cyclosporine and azathioprine. Transplant Proc. 1987 Feb;19(1 Pt 3):2487–2489. [PubMed] [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES