title: The association of HLA-DR antigens with acute steroid-resistant rejection and poor kidney graft survival.
abstract: The association of an early steroid-resistant rejection (SRR) with HLA-DR antigens was analyzed in 410 kidney transplantations. A severe SRR leading to a poor (45%) 1-year graft survival (GS) occurred in 22 transplantations (5%). An acute reversible rejection (ARR) with a GS of 94% was found in 80 transplantations (20%). For the 308 (75%) transplantations with no early rejection episodes the GS was 91%. HLA-DR5 and -DR8 present in the donor as incompatible antigens were strongly associated with SRR. Further, a mismatched DR1 from the kidney donor predicted a rejection, either reversible or irreversible. These findings may have practical implications for an early diagnosis of SRR and for considering of rescue therapy whenever transplantation with disparities in these loci has been performed.
authors.affiliation: Department of Surgery IV, Helsinki University Central Hospital, Finland.
authors.forename: K
authors.initials: K
authors.lastname: Salmela
authors.forename: E
authors.initials: E
authors.lastname: von Willebrand
authors.forename: L
authors.initials: L
authors.lastname: Kyllönen
authors.forename: S
authors.initials: S
authors.lastname: Koskimies
authors.forename: H
authors.initials: H
authors.lastname: Isoniemi
authors.forename: B
authors.initials: B
authors.lastname: Eklund
authors.forename: K
authors.initials: K
authors.lastname: Höckerstedt
authors.forename: J
authors.initials: J
authors.lastname: Ahonen
mesh_terms: D000328:Adult; D004351:Drug Resistance; D005260:Female; D006084:Graft Rejection / Q000187:drug effects / Q000276:immunology*; D006085:Graft Survival / Q000187:drug effects / Q000276:immunology*; D006684:HLA-DR Antigens / Q000032:analysis / Q000276:immunology*; D015798:HLA-DR1 Antigen / Q000276:immunology; D015805:HLA-DR5 Antigen / Q000276:immunology; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008775:Methylprednisolone / Q000494:pharmacology*; D008875:Middle Aged; D014019:Tissue Donors
chemical_list: D006684:HLA-DR Antigens; D015798:HLA-DR1 Antigen; D015805:HLA-DR5 Antigen; D008775:Methylprednisolone