The influence of Duffy blood group on renal allograft outcome in African Americans.
BACKGROUND
African American patients demonstrate higher rates of acute allograft rejection and lower kidney-graft survival compared with white patients. Duffy antigen receptor for chemokines (DARC) on red blood cells has been suggested to have an anti-inflammatory role by acting as a "chemokine sink." We investigated the relationship of Duffy blood group type to renal allograft outcome in African American patient population.


METHODS
A total of 163 African American kidney-transplant recipients were studied for Duffy blood group status. Patient outcomes were assessed at 6 to 42 months after transplantation and monitored for acute rejection episodes, graft function, and graft survival.


RESULTS
A total of 117 (71.8%) patients were Duffy (a-b-), 14 (8.6%) Duffy (a+b-), 21 (12.9%) Duffy (a-b+), and 11 (6.8%) Duffy (a+b+). No significant differences were observed among the groups with respect to median serum-creatinine values or the incidence of biopsy-confirmed acute-rejection episodes. Although only 15.4% of the patients had Duffy (a+) antigen, none lost their allograft during the study period, and Kaplan-Meier graft survival was not significantly different compared to Duffy (a-) group (log-rank test, P=0.12). Duffy (a-b-) patients demonstrated lower allograft survival compared with the other three groups, although statistical significance was not reached (log-rank test P=0.15). Delayed graft function (DGF) was strongly associated with graft failure for only Duffy (a-b-) patients (log-rank test P=0.003).


CONCLUSIONS
Duffy (a-b-) patients have lower allograft survival in the presence of DGF. DARC may attenuate the inflammatory effects of DGF by acting as a "chemokine sink," and DARC-negative patients may be more vulnerable to DGF.
Akalin
Enver
E
Renal Division, Emory University Medical School, Atlanta, GA, USA. enver.akalin@msnyuhealth.org
Neylan
John F
JF
D000293:Adolescent; D000328:Adult; D000368:Aged; D044383:Black People; D002352:Carrier Proteins / Q000502:physiology; D002648:Child; D004375:Duffy Blood-Group System / Q000502:physiology*; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011956:Receptors, Cell Surface / Q000502:physiology; D012307:Risk Factors; D014184:Transplantation, Homologous; D001741:Black or African American
C473745:ACKR1 protein, human; D002352:Carrier Proteins; D004375:Duffy Blood-Group System; D011956:Receptors, Cell Surface