ArticleKidney international2013
Low C4 gene copy numbers are associated with superior graft survival in patients transplanted with a deceased donor kidney.
Article in Kidney international, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Risk Factors for 1-Year Graft Loss After Kidney Transplantation: Systematic Review and Meta-Analysis.Clinical journal of the American Society of Nephrology : CJASN · 2019Pooled it
- Correlation Between C4/IgG with Macroproteinuria in Chronic Kidney Disease: A Pilot Study.ImmunoTargets and therapy · 2024Article
- Precision Medicine in Kidney Transplantation: Just Hype or a Realistic Hope?Transplantation direct · 2021Article
- Complement C4, Infections, and Autoimmune Diseases.Frontiers in immunology · 2021Review
- High-activity Classical and Alternative Complement Pathway Genotypes-Association With Donor-specific Antibody-triggered Injury and Renal Allograft Survival.Transplantation direct · 2020Article
- Impact of complement component 3/4/5 single nucleotide polymorphisms on renal transplant recipients with antibody-mediated rejection.Oncotarget · 2017Article
- Multiallelic copy number variation in the complement component 4A (C4A) gene is associated with late-stage age-related macular degeneration (AMD).Journal of neuroinflammation · 2016Article
- Effects of complement activation on allograft injury.Current opinion in organ transplantation · 2015Review
- The perfect storm: HLA antibodies, complement, FcγRs, and endothelium in transplant rejection.Trends in molecular medicine · 2015Review
- Genotypic variation and outcomes in kidney transplantation: donor and recipient effects.Kidney international · 2013Article
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6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Complement C4 is a central component of the classical and the lectin pathways of the complement system. The C4 protein exists as two isotypes C4A and C4B encoded by the C4A and C4B genes, both of which are found with varying copy numbers. Deposition of C4 has been implicated in kidney graft rejection, but a relationship between graft survival and serum C4 concentration as well as C4 genetic variation has not been established. We evaluated this using a prospective study design of 676 kidney transplant patients and 211 healthy individuals as controls. Increasing C4 gene copy numbers significantly correlated with the C4 serum concentration in both patients and controls. Patients with less than four total copies of C4 genes transplanted with a deceased donor kidney experienced a superior 5-year graft survival (hazard ratio 0.46, 95% confidence interval: 0.25-0.84). No significant association was observed in patients transplanted with a living donor. Thus, low C4 copy numbers are associated with increased kidney graft survival in patients receiving a kidney from a deceased donor. Hence, the degree of ischemia may influence the clinical impact of complement.
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