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HLA class I and class II alleles predispose independently and synergistically to development of pauciarticular juvenile arthritis
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Abstracts
C 5.2.75
HLA CLASS I AND CLASS II ALLELES PREDISPOSE INDEPENDENTLY AND SYNERGISTICALLY TO DEVELOPMENT OF PAUCIARTICULAR JUVENILE ARTHRITIS. MA Fernandez-Vina, AM Lazaro, M Falco, CW Fink and P Stastny, Departments of Internal Medicine and Pediatrics, UT Southwestern Medical Center, Dallas, Texas. Recent studies have shown an association of HLA-A2 with pauciarticular onset juvenile arthritis. We therefore wished to investigate the role of the HLA-A2 subtypes in 115 patients and 162 controls. HLA-A2 was found in 85.4 percent of the persistent pauciarticular (PP) patients (R.R.=6.4, p<0.00001) compared to 47.8 percent of the controls. A slight but non-significant increase of this allele was observed in conversion pauciarticular (CP) (66.6 percent) and polyarticular (POL) onset (60.4 percent). A*0201 was present in 79.2 percent of PP compared to 46.0 percent of the controls (R.R.=4.5 p
C 6.1.76
LACK OF HLA AND TRANSFUSION IMPACT ON REJECTION AND ALLOGRAFT SURVIVAL RH Kerman, PM Kimball, J Williams, C Van Buren, and BD Kahan. University of Texas Medical School, Houston, Texas. We studied 683 CsA-Pred treated 1° renal allograft recipients (recips) to determine whether matching impacts graft survival or rejection. The 1, 3, 5 and 7 year graft survivals of 76%, 66%, 62% and 61% respectively for 237 recips of well matched HLA A, B and DR antigens were not significantly different than those of 71%, 65%, 63% and 63%, respectively, for the 446 poorly matched recips. Sixty percent of recipients experienced no acute rejection (AR) with 1, 3, 5 and 7 year graft survivals of 82%, 78%, 74% and 73%, respectively. Thirtytwo percent of patients who experienced 1 AR had 1, 3, 5 and 7 year graft survivals of 58%, 48%, 44% and 43%, respectively (p<0.01 for of 0 vs. 1 AR). The remaining 8% of the recipients experienced more than 1 ( > 1) AR and had 1, 3, 5 and 7 year graft survival of 62%, 38%, 36% and 36%, respectively (p<0.01 for 0 vs > 1 and 1 vs > 1 AR). The number of ARs/patient experienced by well or poorly matched recips did not differ. Therefore, poorly matched recipients were at comparable risk for acute rejection and did not differ with regard to short and long term graft survivals compared to well matched recipients. However, patients receiving 1-5 preTx transfusions did experience significantly fewer rejections than untransfused recipients (p<0.01), whereas graft survival was no different for transfused or untransfused recipients. Excepting 6 antigen matches, it is concluded that neither obviation of acute rejecion nor improving the likelihood of long-term cadaveric graft survival supports a policy of donor kidney allocation based on HLA matching.
Abstracts
C 5.2.75
HLA CLASS I AND CLASS II ALLELES PREDISPOSE INDEPENDENTLY AND SYNERGISTICALLY TO DEVELOPMENT OF PAUCIARTICULAR JUVENILE ARTHRITIS. MA Fernandez-Vina, AM Lazaro, M Falco, CW Fink and P Stastny, Departments of Internal Medicine and Pediatrics, UT Southwestern Medical Center, Dallas, Texas. Recent studies have shown an association of HLA-A2 with pauciarticular onset juvenile arthritis. We therefore wished to investigate the role of the HLA-A2 subtypes in 115 patients and 162 controls. HLA-A2 was found in 85.4 percent of the persistent pauciarticular (PP) patients (R.R.=6.4, p<0.00001) compared to 47.8 percent of the controls. A slight but non-significant increase of this allele was observed in conversion pauciarticular (CP) (66.6 percent) and polyarticular (POL) onset (60.4 percent). A*0201 was present in 79.2 percent of PP compared to 46.0 percent of the controls (R.R.=4.5 p
C 6.1.76
LACK OF HLA AND TRANSFUSION IMPACT ON REJECTION AND ALLOGRAFT SURVIVAL RH Kerman, PM Kimball, J Williams, C Van Buren, and BD Kahan. University of Texas Medical School, Houston, Texas. We studied 683 CsA-Pred treated 1° renal allograft recipients (recips) to determine whether matching impacts graft survival or rejection. The 1, 3, 5 and 7 year graft survivals of 76%, 66%, 62% and 61% respectively for 237 recips of well matched HLA A, B and DR antigens were not significantly different than those of 71%, 65%, 63% and 63%, respectively, for the 446 poorly matched recips. Sixty percent of recipients experienced no acute rejection (AR) with 1, 3, 5 and 7 year graft survivals of 82%, 78%, 74% and 73%, respectively. Thirtytwo percent of patients who experienced 1 AR had 1, 3, 5 and 7 year graft survivals of 58%, 48%, 44% and 43%, respectively (p<0.01 for of 0 vs. 1 AR). The remaining 8% of the recipients experienced more than 1 ( > 1) AR and had 1, 3, 5 and 7 year graft survival of 62%, 38%, 36% and 36%, respectively (p<0.01 for 0 vs > 1 and 1 vs > 1 AR). The number of ARs/patient experienced by well or poorly matched recips did not differ. Therefore, poorly matched recipients were at comparable risk for acute rejection and did not differ with regard to short and long term graft survivals compared to well matched recipients. However, patients receiving 1-5 preTx transfusions did experience significantly fewer rejections than untransfused recipients (p<0.01), whereas graft survival was no different for transfused or untransfused recipients. Excepting 6 antigen matches, it is concluded that neither obviation of acute rejecion nor improving the likelihood of long-term cadaveric graft survival supports a policy of donor kidney allocation based on HLA matching.