Association of mismatches for HLA-DR with incidence of posttransplant hip fracture in kidney transplant recipients

• Verfasst von: Opelz, Gerhard [VerfasserIn]
• Verfasst von: Döhler, Bernd [VerfasserIn]
• Titel: Association of mismatches for HLA-DR with incidence of posttransplant hip fracture in kidney transplant recipients
• Verf.angabe: Gerhard Opelz and Bernd Döhler
• Jahr: 2011
• Umfang: 5 S.
• Fussnoten: Gesehen am 12.10.2022
• Titel Quelle: Enthalten in: Transplantation
• Ort Quelle: Hagerstown, Md. : Lippincott Williams & Wilkins, 1963
• Jahr Quelle: 2011
• Band/Heft Quelle: 91(2011), 1, Seite 65-69
• ISSN Quelle: 1534-6080
• DOI: doi:10.1097/TP.0b013e3181fa94d6
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1818815737

Abstract

Background. - Bone fractures are a frequent complication after kidney transplantation, for which various predisposing factors have been identified. It has been suggested that human leukocyte antigen (HLA) mismatch increases the risk. - Methods. - Data on hip fractures occurring in the first 5 years posttransplant were analyzed among kidney transplants from deceased donors performed between 1995 and 2008 and reported to the Collaborative Transplant Study. - Results. - In the 20,509 patients analyzed, the cumulative rate of hip fracture by year 5 posttransplant was 0.85%. Cox regression analysis identified the following risk factors: female recipients aged 40 to 59 years (hazard ratio [HR] 2.26, P=0.029), female recipients 60 years or older (HR 5.14, P<0.001), male recipients 60 years or older (HR 2.39, P=0.028), and donor age more than or equal to 60 years (HR 1.75, P=0.009). Using the rate of fractures in recipients with zero HLA-DR mismatch as the reference, the risk of hip fracture increased for grafts with one HLA-DR mismatch to HR 1.85 (95% confidence interval [CI] 1.18-2.89, P=0.007) and with two HLA-DR mismatches to HR 2.24 (CI 1.25-4.02, P=0.007). There was a significant association between the number of HLA-DR mismatches and the diagnosis of osteoporosis 5 years after transplantation: one HLA-DR mismatch risk ratio 1.26 (CI 1.12-1.43, P<0.001) and two HLA-DR mismatches risk ratio 1.45 (CI 1.20-1.74, P<0.001). - Conclusion. - The risk of hip fracture after kidney transplantation seems to be markedly exacerbated by HLA-DR mismatching. These findings add to the growing base of evidence that HLA-DR matching influences morbidity after kidney transplantation.