{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:23:07Z","timestamp":1791296587046,"version":"4.1.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Recent evidence suggests that HLA epitope-mismatching at HLA-DQ loci is associated with the development of anti-DQ donor-specific antibodies and adverse graft outcomes. However, the clinical significance of broad antigen HLA-DQ mismatching for graft outcomes is not well examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting, participants, &amp; measurements<\/jats:title>\n                    <jats:p>Using the United Network Organ Sharing\/the Organ Procurement and Transplantation Network (UNOS\/OPTN) data, patients with primary kidney transplants performed between 2005 and 2014 were included. Patients were classified as having either zero HLA-DQ mismatches, or one or two HLA-DQ mismatches. Primary outcomes were death-censored graft survival and incidence of acute rejection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 93,782 patients were included. Of these, 22,730 (24%) and 71,052 (76%) received zero and one or two HLA-DQ mismatched kidneys, respectively. After adjusting for variables including HLA-ABDR, HLA-DQ mismatching was associated with a higher risk of graft loss in living kidney donor recipients with an adjusted hazard ratio (HR) of 1.18 (95% confidence interval [95% CI], 1.07 to 1.30;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.01), but not in deceased kidney donor recipients (HR, 1.05; 95% CI, 0.98 to 1.12;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.18) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      value for interaction &lt;0.01). When taking cold ischemic time into account, HLA-DQ mismatching was associated with a higher risk of graft loss in deceased kidney donor recipients with cold ischemic time \u226417 hours (HR, 1.12; 95% CI, 1.02 to 1.27;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.002), but not in deceased kidney donor recipients with cold ischemic time &gt;17 hours (HR, 0.97; 95% CI, 0.88 to 1.06;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.49) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      value for interaction &lt;0.01). Recipients with one or two HLA-DQ mismatched kidneys had a higher incidence of acute rejection at 1 year, with adjusted odds ratios of 1.13 (95% CI, 1.03 to 1.23;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.01) in deceased donor and 1.14 (95% CI, 1.03 to 1.27;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.02) in living donor kidney transplant recipients. Specific donor-DQ mismatches seemed to be associated with the risk of acute rejection and graft failure, whereas others did not.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HLA-DQ mismatching is associated with lower graft survival independent of HLA-ABDR in living donor kidney transplants and deceased donor kidney transplants with cold ischemia time \u226417 hours, and a higher 1-year risk of acute rejection in living and deceased donor kidney transplants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.10860917","type":"journal-article","created":{"date-parts":[[2018,4,23]],"date-time":"2018-04-23T08:50:12Z","timestamp":1524473412000},"page":"763-771","source":"Crossref","is-referenced-by-count":72,"title":["HLA-DQ Mismatching and Kidney Transplant Outcomes"],"prefix":"10.2215","volume":"13","author":[{"given":"Napat","family":"Leeaphorn","sequence":"first","affiliation":[{"name":"Transplant Institute, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy Ryan A.","family":"Pena","sequence":"additional","affiliation":[{"name":"Division of Laboratory and Transfusion Medicine, Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natanong","family":"Thamcharoen","sequence":"additional","affiliation":[{"name":"Transplant Institute, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliyahu V.","family":"Khankin","sequence":"additional","affiliation":[{"name":"Transplant Institute, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Pavlakis","sequence":"additional","affiliation":[{"name":"Transplant Institute, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Cardarelli","sequence":"additional","affiliation":[{"name":"Transplant Institute, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,4,23]]},"reference":[{"key":"B1-20230816","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1097\/01.tp.0000269725.74189.b9","article-title":"Effect of human leukocyte antigen compatibility on kidney graft survival: Comparative analysis of two decades.","volume":"84","author":"Opelz","year":"2007","journal-title":"Transplantation"},{"key":"B2-20230816","doi-asserted-by":"crossref","first-page":"E428","DOI":"10.1111\/j.1399-0012.2012.01654.x","article-title":"Human leukocyte antigen mismatches associated with increased risk of rejection, graft failure, and death independent of initial immunosuppression in renal transplant 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antigen HLA mismatches, eplet HLA mismatches and acute rejection after kidney transplantation.","volume":"2","author":"Do Nguyen","year":"2016","journal-title":"Transplant Direct"},{"key":"B16-20230816","doi-asserted-by":"crossref","first-page":"4603","DOI":"10.1182\/blood-2013-02-481945","article-title":"Multiple mismatches at the low expression HLA loci DP, DQ, and DRB3\/4\/5 associate with adverse outcomes in hematopoietic stem cell transplantation.","volume":"121","author":"Fern\u00e1ndez-Vi\u00f1a","year":"2013","journal-title":"Blood"},{"key":"B17-20230816","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1111\/tri.12316","article-title":"DQ molecules are the principal stimulators of de novo donor-specific antibodies in nonsensitized pediatric recipients receiving a first kidney transplant.","volume":"27","author":"Tagliamacco","year":"2014","journal-title":"Transpl 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