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Genetic match critical in kidney transplant

Wednesday February 20th, 2019

Several genetic characteristics are important in donor-recipient compatibility in kidney transplants, Austrian researchers have found.

Transplant survival is known to be linked to matching in one area of the major histocompatibility complex on chromosome 6. Half of all transplanted kidneys still fail within 15 years, the researchers say.

Dr Rainer Oberbauer and his colleagues at the Medical University Vienna, Austria, examined a range of other potentially important factors in order to pin down genetic characteristics of successful matches.

The new research involved genotyping 477 pairs of deceased donors and kidney transplant recipients with stable graft function at three months, from several countries. It focused on conformance in non-synonymous single nucleotide polymorphisms (nsSNPs).

Results, published on 15 February in The Lancet, confirm the fundamental importance of compatibility in many of these genetic regions. The degree of nsSNP mismatch was linked to rejection of the transplanted kidney.

The authors write: “We were able to confirm this experimentally by the determination of donor-specific antibodies against these non-conforming regions.”

They suggest that a genome-wide analysis of both donor and recipient should be done before transplantation of living donor kidneys to check the match.

“This has been done routinely [at the Medical University Vienna]," they write, “and with very good success for several years now in the case of poor tissue conformance in the main histocompatibility complex.”

http://dx.doi.org/10.1016/S0140-6736(18)32473-5

Reindl-Schwaighofer, R. et al. Contribution of non-HLA incompatibility between donor and recipient to kidney allograft survival: genome-wide analysis in a prospective cohort. The Lancet 14 February 2019

https://doi.org/10.1016/S0140-6736(18)32473-5

Tags: Europe | Genetics | Transplant

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