{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:56:46Z","timestamp":1753891006636,"version":"3.41.2"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T00:00:00Z","timestamp":1663113600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p><jats:italic>De novo<\/jats:italic> thrombotic microangiopathy (TMA) is associated with poor kidney graft survival, and as we previously described, it is a recipient driven process with suspected genetic background. Direct Sanger sequencing was performed in 90 KTR with <jats:italic>de novo<\/jats:italic> TMA and 90 corresponding donors on selected regions in <jats:italic>CFH, CD46, C3<\/jats:italic>, and <jats:italic>CFB<\/jats:italic> genes that involve variations with a functional effect or confer a risk for aHUS. Additionally, 37 recipients of paired kidneys who did not develop TMA were analyzed for the <jats:italic>MCPggaac<\/jats:italic> haplotype. Three-years death-censored graft survival was assessed using Kaplan-Meier and Cox regression models. The distribution of haplotypes in all groups was in the Hardy-Weinberg equilibrium and there was no clustering of haplotypes in any group. In the TMA group, we found that <jats:italic>MCPggaac<\/jats:italic> haplotype carriers were at a significantly higher risk of graft loss compared to individuals with the wild-type genotype. Worse 3-year death-censored graft survival was associated with longer cold ischemia time (HR 1.20, 95% CI 1.06, 1.36) and recipients\u2019 <jats:italic>MCPggaac<\/jats:italic> haplotype (HR 3.83, 95% CI 1.42, 10.4) in the multivariable Cox regression model. There was no association between donor haplotypes and kidney graft survival. Similarly, there was no effect of the <jats:italic>MCPggaac<\/jats:italic> haplotype on 3-year graft survival in recipients of paired kidneys without <jats:italic>de novo<\/jats:italic> TMA. Kidney transplant recipients carrying the <jats:italic>MCPggaac<\/jats:italic> haplotype with <jats:italic>de novo<\/jats:italic> TMA are at an increased risk of premature graft loss. These patients might benefit from therapeutic strategies based on complement inhibition.<\/jats:p>","DOI":"10.3389\/fimmu.2022.985766","type":"journal-article","created":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T09:25:42Z","timestamp":1663147542000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["MCPggaac haplotype is associated with poor graft survival in kidney transplant recipients with de novo thrombotic microangiopathy"],"prefix":"10.3389","volume":"13","author":[{"given":"Vojtech","family":"Petr","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorottya","family":"Csuka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petra","family":"Hruba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1gnes","family":"Szil\u00e1gyi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marek","family":"Kollar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonij","family":"Slavcev","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zolt\u00e1n","family":"Proh\u00e1szka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ondrej","family":"Viklicky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1097\/TXD.0000000000001239","article-title":"Rejection-associated 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