Abstract
Although the genetic polymorphism of Stromal Cell-Derived Factor 1 (SDF-1) is associated with higher mortality of liver allograft recipients, the role of SDF-1 in the modulation of renal allograft outcomes is unclear. Between March 2000 and January 2008, we recruited 252 non-diabetic renal transplant recipients (RTRs). Baseline characteristics and blood chemistry were recorded. Genomic DNA extraction with polymerase chain reaction-restriction fragment length polymorphism was utilized to analyze the genetic polymorphisms of SDF-1 (rs1801157). The influence of SDF-1 on an adverse renal allograft outcome, defined as either a doubling of serum creatinine, graft failure, or patient death was evaluated. Sixteen patients with the SDF-1 AA/AG genotype and nine with the SDF-1 GG genotype reached an adverse outcome. According to Kaplan-Meier analysis, patients carrying the SDF-1 AA/AG genotype or A allele showed a significantly higher risk of reaching an adverse outcome than those carrying the SDF-1 GG genotype or G allele (p = 0.041; p = 0.0051, respectively; log rank test). Stepwise multivariate Cox proportional regression analysis revealed that patients carrying the SDF-1 AA/AG genotype and A allele had a 2.742-fold (95% CI. 1.106–6.799, p = 0.03) and 2.306-fold (95% CI. 1.254–4.24, p = 0.008) risk of experiencing an adverse outcome. The SDF-1 AA/AG genotype and A allele have a detrimental impact on the long-term outcome of RTRs.
Highlights
The outcome of renal allograft is determined by a combination of risk factors including immunologic risk factors, such as delayed graft function (DGF), acute rejection, hepatitis B (HBV), and hepatitis C
We recently found that pre-diabetic patients and post-transplant diabetic mellitus (PTDM) had more adverse long-term renal allograft outcomes than those without DM [20]
We report that non-DM renal transplant recipients (RTRs) who carried the Stromal Cell-Derived Factor 1 (SDF-1) genotype AA/AG or an allele A had a higher risk of an adverse long-term allograft outcome in comparison to those who had the SDF-1 GG genotype or a G allele
Summary
The outcome of renal allograft is determined by a combination of risk factors including immunologic risk factors, such as delayed graft function (DGF), acute rejection, hepatitis B (HBV), and hepatitis C (HCV) infection as well as non-immunologic risk factors, such as hypertension (HTN), hyperlipidemia, and hyperglycemia [1,2,3]. It has been reported that single nucleotide polymorphisms (SNPs) contribute to short and long term outcomes [4,5], including DGF, chronic allograft dysfunction, and graft rejection [6,7]. Anders et al reported that SDF-1-CXCR4 function is necessary to maintain homeostatic tissue renewal and regeneration upon renal injury [8]. SDF-1 (rs1801157) is located on chromosome 10q 11.1. A guanine to adenine (G to A) SNP at position
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