Kidney Transplant Research - Risks, Prognosis, Procedure, Surgery, Organ Donation

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Impact of NOD2/CARD15 haplotypes on the outcome after kidney transplantation.

Krüger B, Böger CA, Schröppel B, Obed A, Hoffmann U, Murphy BT, Fischereder M, Holler E, Banas B, Krämer BK

Klinik und Poliklinik für Innere Medizin II-Nephrologie, Universität Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany. bernd.krueger@klinik.uni-regensburg.de

Chronic allograft nephropathy and (cardiovascular) death with functioning graft are major causes of late graft loss. NOD2/CARD15 (nucleotide oligomerization domain-2/caspase-recruiting activating domain-15), an intracellular receptor that is part of the innate immunity repertoire, has convincingly been shown to be involved in infection/inflammation-associated diseases. Specifically, NOD2/CARD15 polymorphisms are clearly associated with Crohn's disease and transplant-associated mortality after bone marrow transplantation. The aim of this study was to clarify the relevance of NOD2/CARD15-haplotypes in kidney transplantation. Three hundred fifty-two patients receiving their first kidney transplant were genotyped for the three major NOD2/CARD15 polymorphisms, R702W, G908R, and 1007fs with subsequent reconstruction of the different haplotypes. Four different NOD2/CARD15 haplotypes were observed in our population [CG(-): 89.8%, CGC: 3.5%, CC(-): 1.6%, TG(-): 5.1%]. After stratifying the different haplotypes into diplotypes (wild type: CG(-)/CG(-), n=284, mutated haplotype, n=68) we found a significant association with all-cause and cardiovascular mortality, also after adjusting to different covariates, and (only) in univariate analysis with graft survival. In conclusion, we found different effects of the NOD2/CARD15 haplotypes on disorders, like cardiovascular and all-cause mortality,which may be considered at least in part as chronic inflammation-driven. Further studies are needed to confirm and work out the association between these disorders and the NOD2/CARD15 haplotypes.

Published 18 July 2007 in Transpl Int, 20(7): 600-7.
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Kidney Transplant Books

Handbook of Kidney and Pancreas Transplantation (Vademecum)

Handbook of Kidney and Pancreas Transplantation (Vademecum)