title: Impact of HLA mismatching on incidence of posttransplant non-hodgkin lymphoma after kidney transplantation.
abstract: BACKGROUND
  Posttransplant non-Hodgkin lymphoma is a rare complication but associated with high mortality. The extent to which human leukocyte antigen (HLA) mismatching influences the rate of posttransplant lymphoma has not been clarified.
  
  
  METHODS
  Data on lymphomas occurring in the first 3 years posttransplant were analyzed among first kidney transplants from deceased donors performed between 1985 and 2007 and reported to the Collaborative Transplant Study.
  
  
  RESULTS
  Of 152,728 patients included, 593 non-Hodgkin lymphomas were diagnosed. Cox multivariate regression analysis showed that HLA-A mismatches had no influence on the rate of lymphoma. One and two HLA-DR mismatches were associated with a hazard ratio (HR) of 1.21 (95% confidence interval 1.00-1.45, P=0.047) and 1.56 (95% confidence interval 1.21-1.99, P<0.001), respectively. For lymphoma of the kidney and central nervous system, HRs for two HLA-DR mismatches were 2.29 (P=0.007) and 2.17 (P=0.029), respectively. Two HLA-B mismatches were also significantly associated with lymphoma in the kidney (HR 2.82, P=0.009).
  
  
  CONCLUSIONS
  Mismatches at the HLA-DR locus are a significant risk factor for posttransplant non-Hodgkin lymphoma, particularly in the kidney and central nervous system, whereas two HLA-B mismatches increase the risk for the development of lymphoma of the kidney.
authors.affiliation: Department of Transplantation Immunology, University of Heidelberg, Im Neuenheimer Feld 305, D-61920 Heidelberg, Germany. gerhard.opelz@med.uni-heidelberg.de
authors.forename: Gerhard
authors.initials: G
authors.lastname: Opelz
authors.forename: Bernd
authors.initials: B
authors.lastname: Döhler
mesh_terms: D000293:Adolescent; D000328:Adult; D003710:Demography; D005260:Female; D006680:HLA Antigens / Q000276:immunology*; D006684:HLA-DR Antigens / Q000276:immunology; D006650:Histocompatibility Testing / Q000379:methods; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology* / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000473:pathology; D055815:Young Adult
chemical_list: D006680:HLA Antigens; D006684:HLA-DR Antigens