title: CC chemokine receptor 5 and renal-transplant survival.
abstract: BACKGROUND
  About 1% of white populations are homozygous carriers of an allele of the gene for the CC chemokine receptor 5 (CCR5) with a 32 bp deletion (CCR5Delta32), which leads to an inactive receptor. During acute and chronic transplant rejection, ligands for CCR5 are upregulated, and the graft is infiltrated by CCR5-positive mononuclear cells. We therefore investigated the influence of CCR5Delta32 on renal-transplant survival.
  
  
  METHODS
  Genomic DNA from peripheral-blood leucocytes of 1227 renal-transplant recipients was screened by PCR for the presence of CCR5Delta32. Demographic and clinical data were extracted from hospital records. Complete follow-up data were available for 576 recipients of first renal transplants. Graft survival was analysed by Fisher's exact test and Kaplan-Meier plots compared with a log-rank test.
  
  
  RESULTS
  PCR identified 21 patients homozygous for CCR5Delta32 (frequency 1.7%). One patient died with a functioning graft. Only one of the remaining patients lost transplant function during follow-up (median 7.2 years) compared with 78 of the 555 patients with a homozygous wild-type or heterozygous CCR5Delta32 genotype. Graft survival was significantly longer in the homozygous CCR5Delta32 group than in the control group (log-rank p=0.033; hazard ratio 0.367 [95% CI 0.157-0.859]).
  
  
  CONCLUSIONS
  Patients homozygous for CCR5Delta32 show longer survival of renal transplants than those with other genotypes, suggesting a pathophysiological role for CCR5 in transplant loss. This receptor may be a useful target for the prevention of transplant loss.
authors.affiliation: Medizinische Poliklinik, Klinikum der Universität München, Pettenkoferstrasse 8a, D-80336, München, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Fischereder
authors.forename: B
authors.initials: B
authors.lastname: Luckow
authors.forename: B
authors.initials: B
authors.lastname: Hocher
authors.forename: R P
authors.initials: RP
authors.lastname: Wüthrich
authors.forename: U
authors.initials: U
authors.lastname: Rothenpieler
authors.forename: H
authors.initials: H
authors.lastname: Schneeberger
authors.forename: U
authors.initials: U
authors.lastname: Panzer
authors.forename: R A
authors.initials: RA
authors.lastname: Stahl
authors.forename: I A
authors.initials: IA
authors.lastname: Hauser
authors.forename: K
authors.initials: K
authors.lastname: Budde
authors.forename: H
authors.initials: H
authors.lastname: Neumayer
authors.forename: B K
authors.initials: BK
authors.lastname: Krämer
authors.forename: W
authors.initials: W
authors.lastname: Land
authors.forename: D
authors.initials: D
authors.lastname: Schlöndorff
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D015894:Genome, Human; D005838:Genotype; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D019713:Receptors, CCR5 / Q000235:genetics*
chemical_list: D019713:Receptors, CCR5