Incidence of Donor and Recipient Toll-Like Receptor-4 Polymorphisms in Kidney Transplantation

Abstract

Toll-like receptors (TLR) comprise an emerging family that recognize pathogen-associated molecular patterns and promote the activation of leukocytes. Recently, TLR has been demonstrated to play a role in experimental allograft rejection. However, the TLR-4 gene has a polymorphism that can be associated with a blunted immune response, especially to microbial pathogens. We sought to study the incidence of TLR 4 gene variants among renal transplant donors and recipients from living and deceased organs and then to correlate them with short-term and long-term outcomes. Methods Analysis of TLR4 polymorphisms at Asp299Gly and Thr399Ile codons were performed using restriction fragment length polymorphism. Demographic data was obtained from patient records. Results Among 201 patients, 141 were recipients from related donors (group 1) and 60 recipients from 45 deceased donors (group 2). Patients were followed for 108 ± 85 months after transplantation. The incidence of polymorphism for TLR-4 Asp299Gly, Thr399Ile or both were 8.9% in recipients and 8.0% in donors. Patients who received a kidney with polymorphism, Asp299Gly, or Thr399Ile, or both, did not show a difference in rate of acute tubular necrosis compared with controls (no polymorphism). Acute rejection occurred in 17.6% of recipients with Asp299Gly/Thr399Ile polymorphisms and in 39.5% of wild-type recipients ( P = .400). The incidence of bacterial infection was equal in both groups. Conclusion The incidence of polymorphism in this study was similar in both groups, and donor or recipient polymorphisms were not associated with different renal graft outcomes.