HLA Loci and Recurrence of Focal Segmental Glomerulosclerosis in Pediatric Kidney Transplantation.
Abstract
Recurrent focal segmental glomerulosclerosis (FSGS) after kidney transplantation accounts
for the majority of allograft failures in children with primary FSGS. Although current
research focuses on FSGS pathophysiology, a common etiology and mechanisms of disease
recurrence remain elusive.<h4>Methods</h4>We performed a retrospective review of the
Scientific Registry of Transplant Recipients to determine the association of specific
HLA recurrence of FSGS. Kidney transplants recipients under the age of 19 who were
diagnosed with FSGS, who were transplanted after January 1, 2000, and who had complete
HLA data were included in the study. We performed simple logistic regression on all
HLA A, B, C, DR, and DQ represented in the dataset and FSGS recurrence and then determined
those associated with recurrence using the Benjamini-Hochberg method for multiple
comparisons. For those HLAs that were associated with recurrence, we further determined
the effect of matching recipient and donor HLA with recurrence.<h4>Results</h4>HLA
DR7, DR53, DQ2, DR52, and DQ7 were associated with increased or decreased risk of
recurrent disease after transplantation. We identified a risk haplotype consisting
of HLA-DR7, DR53, and DQ2 that was consistently associated with an increased risk
of recurrence (odds ratio 1.91; 95% confidence interval, 1.44-2.54, P < 0.001). We also found that donor/recipient concordance for HLA-DQ7 was associated
with a decreased risk of recurrence (odds ratio 0.42; 95% confidence interval, 0.37-0.53,
<i>P</i> = 0.009).<h4>Conclusions</h4>HLA profiles may be used for risk stratification
of recurrence of FSGS in pediatric kidney transplant recipients and deserves further
study.
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https://hdl.handle.net/10161/23898Published Version (Please cite this version)
10.1097/txd.0000000000001201Publication Info
Shaw, Brian I; Ochoa, Alejandro; Chan, Cliburn; Nobuhara, Chloe; Gbadegesin, Rasheed;
Jackson, Annette M; & Chambers, Eileen T (2021). HLA Loci and Recurrence of Focal Segmental Glomerulosclerosis in Pediatric Kidney
Transplantation. Transplantation direct, 7(10). pp. e748. 10.1097/txd.0000000000001201. Retrieved from https://hdl.handle.net/10161/23898.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Eileen Tsai Chambers
Associate Professor of Pediatrics
Chi Wei Cliburn Chan
Professor of Biostatistics & Bioinformatics
Computational immunology (stochastic and spatial models and simulations, T cell signaling,
immune regulation) Statistical methodology for immunological laboratory techniques
(flow cytometry, CFSE analysis, receptor-ligand binding and signaling kinetics) Informatics
of the immune system (reference and application ontologies, meta-programming, text
mining and machine learning)
Rasheed Adebayo Gbadegesin
Wilburt C. Davison Distinguished Professor
Molecular genetics of glomerular disease Genetic risk factors for childhood onset
idiopathic nephrotic syndrome
Annette M Jackson
Associate Professor in Surgery
Alejandro Ochoa
Assistant Professor of Biostatistics & Bioinformatics
Research in statistical genetics and computational biology. Focused on estimation
of population structure / relatedness and applications, including GWAS, heritability
estimation, and admixture.
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