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Immunogenetic factors that may contribute to ethnic differences in renal allograft survival.
Clin Transplant. 1996 Dec; 10(6 Pt 2):620-4.CT

Abstract

In the United States, allocation of cadaveric kidneys is federally regulated and based on the concept of equal access to all patients, regardless of race, sex, age, or socioeconomic status. Nevertheless, it has been widely reported that African American patients with renal disease wait longer for kidney transplantation and, once transplanted, have poorer graft survival. We have assessed immunogenetic factors that may contribute to ethnic differences in allograft survival by examining the distributions of ABO blood groups, HLA antigens and haplotypes, percent reactive antibody (PRA), age, and gender in our local patient population. Approximately 62% of patients at our transplant center waiting for renal transplantation are African American; 39% are female. Age distribution is comparable to that reported nationally. ABO blood groups of patients on the waiting list are distributed similarly to those reported nationally for other renal patients. Sensitization to HLA antigens, through either blood transfusion, prior transplant, or pregnancy, has been strongly associated with poorer graft survival. Although, as expected, distribution of PRA was significantly different for males versus females at one time point, it did not differ between ethnic groups in our patient population. HLA polymorphism was assessed by comparisons of HLA allele and haplotype frequencies determined by analyses of African American and Caucasian families typed in our program since 1991. Haplotypes observed in each ethnic population were subjected to a variety of statistical analyses. Coefficient of contingency and Cramer's V statistic (measures of degree of association) were consistently higher for Caucasian haplotypes than for those of African Americans. Significantly more unique HLA haplotypes were observed among African American families than among Caucasian families. Thus, our data provide evidence for greater HLA linkage disequilibrium in Caucasians than in African Americans. HLA antigen and haplotype polymorphisms are likely, therefore, to be major immunogenetic factors contributing to ethnic differences in renal allograft survival.

Authors+Show Affiliations

Transplant Laboratory, Durham Veterans Affairs Medical Center, North Carolina, USA.No affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

8996754

Citation

Ward, F E., and J M. MacQueen. "Immunogenetic Factors That May Contribute to Ethnic Differences in Renal Allograft Survival." Clinical Transplantation, vol. 10, no. 6 Pt 2, 1996, pp. 620-4.
Ward FE, MacQueen JM. Immunogenetic factors that may contribute to ethnic differences in renal allograft survival. Clin Transplant. 1996;10(6 Pt 2):620-4.
Ward, F. E., & MacQueen, J. M. (1996). Immunogenetic factors that may contribute to ethnic differences in renal allograft survival. Clinical Transplantation, 10(6 Pt 2), 620-4.
Ward FE, MacQueen JM. Immunogenetic Factors That May Contribute to Ethnic Differences in Renal Allograft Survival. Clin Transplant. 1996;10(6 Pt 2):620-4. PubMed PMID: 8996754.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Immunogenetic factors that may contribute to ethnic differences in renal allograft survival. AU - Ward,F E, AU - MacQueen,J M, PY - 1996/12/1/pubmed PY - 1996/12/1/medline PY - 1996/12/1/entrez SP - 620 EP - 4 JF - Clinical transplantation JO - Clin Transplant VL - 10 IS - 6 Pt 2 N2 - In the United States, allocation of cadaveric kidneys is federally regulated and based on the concept of equal access to all patients, regardless of race, sex, age, or socioeconomic status. Nevertheless, it has been widely reported that African American patients with renal disease wait longer for kidney transplantation and, once transplanted, have poorer graft survival. We have assessed immunogenetic factors that may contribute to ethnic differences in allograft survival by examining the distributions of ABO blood groups, HLA antigens and haplotypes, percent reactive antibody (PRA), age, and gender in our local patient population. Approximately 62% of patients at our transplant center waiting for renal transplantation are African American; 39% are female. Age distribution is comparable to that reported nationally. ABO blood groups of patients on the waiting list are distributed similarly to those reported nationally for other renal patients. Sensitization to HLA antigens, through either blood transfusion, prior transplant, or pregnancy, has been strongly associated with poorer graft survival. Although, as expected, distribution of PRA was significantly different for males versus females at one time point, it did not differ between ethnic groups in our patient population. HLA polymorphism was assessed by comparisons of HLA allele and haplotype frequencies determined by analyses of African American and Caucasian families typed in our program since 1991. Haplotypes observed in each ethnic population were subjected to a variety of statistical analyses. Coefficient of contingency and Cramer's V statistic (measures of degree of association) were consistently higher for Caucasian haplotypes than for those of African Americans. Significantly more unique HLA haplotypes were observed among African American families than among Caucasian families. Thus, our data provide evidence for greater HLA linkage disequilibrium in Caucasians than in African Americans. HLA antigen and haplotype polymorphisms are likely, therefore, to be major immunogenetic factors contributing to ethnic differences in renal allograft survival. SN - 0902-0063 UR - https://www.unboundmedicine.com/medline/citation/8996754/Immunogenetic_factors_that_may_contribute_to_ethnic_differences_in_renal_allograft_survival_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=8996754.ui DB - PRIME DP - Unbound Medicine ER -