H-Y Incompatibility Predicts Short-Term Outcomes for Kidney Transplant
Kim SJ, Gill JS. J Am Soc Nephrol. 2009 Sep;20(9):2025-33
A recent registry analysis suggested that female recipients of a male kidney are an increased risk for graft loss. The putative mechanism was the minor histocompatibility antigen H-Y. This study repeated this analysis in a different registry. It found a slightly higher risk of graft loss for
female recipients of male kidneys at 1 year, but no difference at 10 years. The mechanisms responsible for this difference are unknown.Â
Full text provided to Nephrology Now users by the American Society of Nephrology.
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Abstract:
A recent report suggested that female recipients of male deceased-donor kidneys are at increased risk for graft failure because of H-Y antigen mismatch. In an attempt to confirm and extend these results, we studied all adult recipients of deceased-donor kidney transplants from 1990 through 2004 in the US Renal Data System. Compared with all other gender combinations, female recipients of male donor kidneys had a 12% increased risk for graft failure at 1 yr (hazard ratio 1.12; 95% confidence interval 1.05 to 1.19) but no excess risk at 10 yr (hazard ratio 1.03; 95% confidence interval 0.98 to 1.07). We observed a similar pattern of short- and long-term risk for both death-censored graft failure and mortality. The main results were consistent across several prespecified patient subgroups and were robust to sensitivity analyses. In conclusion, compared with other recipient-donor gender combinations, female recipients of male donor kidney transplants in the United States have an increased short-term risk but not long-term risk for adverse outcomes.
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