Association of donor inflammation- and apoptosis-related genotypes and delayed allograft function after kidney transplantation.


BACKGROUND Delayed renal allograft survival (delayed graft function [DGF]) after deceased donor kidney transplantation is associated with an increased risk of allograft loss. Inflammatory response and apoptosis are associated with increased risk of DGF. STUDY DESIGN Cross-sectional study. SETTING & PARTICIPANTS We first recruited 616 recipients of kidneys from 512 deceased kidney donors, and donor DNA was genotyped. These recipients, who were included in a prospective cohort study of 9 transplant centers in the Delaware Valley region, had their DGF outcome obtained through medical record abstraction. We then identified the recipient (n = 349) of the contralateral deceased kidney donor, if not part of the cohort, through the US Renal Data System registry. The final cohort consisted of 965 recipients of deceased donor kidneys from 512 donors. PREDICTORS Donor single-nucleotide polymorphisms in genes for tumor necrosis factor alpha (TNF), transforming growth factor beta1 (TGFB1), interleukin 10 (IL10), p53 (TP53), and heme oxygenase 1 (HMOX1). OUTCOMES DGF, defined as the need for dialysis therapy in the first week posttransplantation. Secondary outcomes included acute rejection and estimated glomerular filtration rate. MEASUREMENTS Information for DGF, acute rejection, and estimated glomerular filtration rate for recipients in the Delaware Valley Cohort was obtained through medical record abstraction. For other recipients, information for DGF was obtained from United Network for Organ Sharing forms and Centers for Medicare & Medicaid Services claims in the US Renal Data System registry. RESULTS No association was detected between the TGFB1, IL10, TP53, and HMOX1 genes and DGF. The G allele of the TNF polymorphism rs3093662 was associated with DGF in an adjusted analysis (odds ratio, 1.85 compared with A allele; 95% confidence interval, 1.16 to 2.96; P = 0.01). However, this association did not achieve statistical significance after adjusting for multiple comparisons. LIMITATIONS Inadequate sample size for infrequent genotypes and multiple comparisons. CONCLUSION Because of the low frequency of donor single-nucleotide polymorphisms of interest, a larger sample size and replication are necessary to confirm these findings on the association of donor genotypes with DGF.

DOI: 10.1053/j.ajkd.2008.05.006

Cite this paper

@article{Israni2008AssociationOD, title={Association of donor inflammation- and apoptosis-related genotypes and delayed allograft function after kidney transplantation.}, author={Ajay K Israni and Na Li and Bojana B. Cizman and Jon J Snyder and John D Abrams and Marshall M. Joffe and Timothy Rebbeck and Harold I. Feldman}, journal={American journal of kidney diseases : the official journal of the National Kidney Foundation}, year={2008}, volume={52 2}, pages={331-9} }