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.

Methods

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.

Results

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, P = 0.009).

Conclusions

HLA profiles may be used for risk stratification of recurrence of FSGS in pediatric kidney transplant recipients and deserves further study.

Department

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Citation

Published Version (Please cite this version)

10.1097/txd.0000000000001201

Publication Info

Shaw, Brian I, Alejandro Ochoa, Cliburn Chan, Chloe Nobuhara, Rasheed Gbadegesin, Annette M Jackson and Eileen T Chambers (2021). HLA Loci and Recurrence of Focal Segmental Glomerulosclerosis in Pediatric Kidney Transplantation. Transplantation direct, 7(10). p. e748. 10.1097/txd.0000000000001201 Retrieved from https://hdl.handle.net/10161/23898.

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Scholars@Duke

Ochoa

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.

Chan

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)

Gbadegesin

Rasheed Adebayo Gbadegesin

Wilburt C. Davison Distinguished Professor

Molecular genetics of glomerular disease
Genetic risk factors for childhood onset idiopathic nephrotic syndrome


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