{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:38:32Z","timestamp":1792165112954,"version":"4.4.0"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2012,6,4]],"date-time":"2012-06-04T00:00:00Z","timestamp":1338768000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2012,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Human leukocyte antigen (<jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>) mismatches have been shown to adversely affect renal allograft outcomes and remain an important component of the allocation of deceased donor (<jats:styled-content style=\"fixed-case\">DD<\/jats:styled-content>) kidneys. The ongoing importance of <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content> mismatches on transplant outcomes in the era of more potent immunosuppression remains debatable. Using <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ustralia and <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>ew <jats:styled-content style=\"fixed-case\">Z<\/jats:styled-content>ealand <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>ialysis and <jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>ransplant <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>egistry, live and <jats:styled-content style=\"fixed-case\">DD<\/jats:styled-content> renal transplant recipients between 1998 and 2009 were examined. The association between the number of <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content> mismatches and <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\u2010loci mismatches and outcomes were examined. Of the 8036 renal transplant recipients, 59% had between 2 and 4 <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content> mismatches. Compared with 0 <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content> mismatch, increasing <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content> mismatches were associated with a higher risk of graft failure and patient death in the adjusted models. <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content> mismatches were associated with an incremental risk of rejection although the relative risk was higher for live donor kidney transplants. Increasing <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">AB<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DR<\/jats:styled-content> mismatches were associated with a greater risk of acute rejection, graft failure, death\u2010censored graft failure, and\/or death. There was no consistent association between initial immunosuppressive regimen and outcomes. Our results corroborate and extend the previous registry analyses demonstrating that <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content> mismatches are associated with poorer transplant outcomes independent of immunosuppression and transplant era.<\/jats:p>","DOI":"10.1111\/j.1399-0012.2012.01654.x","type":"journal-article","created":{"date-parts":[[2012,6,4]],"date-time":"2012-06-04T18:13:16Z","timestamp":1338833596000},"source":"Crossref","is-referenced-by-count":91,"title":["Human leukocyte antigen mismatches associated with increased risk of rejection, graft failure, and death independent of initial immunosuppression in renal transplant recipients"],"prefix":"10.1111","volume":"26","author":[{"given":"Wai H.","family":"Lim","sequence":"first","affiliation":[{"name":"Department of Renal Medicine Sir Charles Gairdner Hospital Perth WA Australia"},{"name":"ANZDATA Registry Adelaide SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve J.","family":"Chadban","sequence":"additional","affiliation":[{"name":"ANZDATA Registry Adelaide SA Australia"},{"name":"Renal Unit Royal Prince Alfred Hospital Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Clayton","sequence":"additional","affiliation":[{"name":"ANZDATA Registry Adelaide SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charley A.","family":"Budgeon","sequence":"additional","affiliation":[{"name":"Centre for Applied Statistics University of Western Australia Perth WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Murray","sequence":"additional","affiliation":[{"name":"Centre for Applied Statistics University of Western Australia Perth WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott B.","family":"Campbell","sequence":"additional","affiliation":[{"name":"ANZDATA Registry Adelaide SA Australia"},{"name":"Renal Unit Princess Alexandra Hospital Brisbane Qld. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solomon","family":"Cohney","sequence":"additional","affiliation":[{"name":"ANZDATA Registry Adelaide SA Australia"},{"name":"Renal Unit Royal Melbourne Hospital Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graeme R.","family":"Russ","sequence":"additional","affiliation":[{"name":"ANZDATA Registry Adelaide SA Australia"},{"name":"Nephrology and Transplantation Services Royal Adelaide Hospital Adelaide SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen P.","family":"McDonald","sequence":"additional","affiliation":[{"name":"ANZDATA Registry Adelaide SA Australia"},{"name":"Nephrology and Transplantation Services Royal Adelaide Hospital Adelaide SA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,6,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e31816349b5"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800810432"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199409223311203"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199807150-00006"},{"key":"e_1_2_6_6_1","first-page":"391","article-title":"Rejection episodes","author":"Koyama H","year":"1992","journal-title":"Clin Transpl"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.tp.0000269725.74189.b9"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199104113241505"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200010123431504"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199911043411906"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/17.5.884"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2004.00535.x"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e318199c1c7"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa025056"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.tp.0000261108.27421.bc"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0041-1345(98)01748-5"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2011.09.023"},{"key":"e_1_2_6_18_1","first-page":"455","article-title":"Summary of the effect of de novo HLA antibodies on chronic kidney graft failure","author":"Terasaki P","year":"2006","journal-title":"Clin Transpl"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1399-0012.2012.01654.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1399-0012.2012.01654.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T22:10:37Z","timestamp":1695507037000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1399-0012.2012.01654.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,6,4]]},"references-count":17,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2012,7]]}},"alternative-id":["10.1111\/j.1399-0012.2012.01654.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1399-0012.2012.01654.x","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,6,4]]}}}