Evidence map›Paper›PMID 42304306›Full record

ArticleBMC nephrology2026

Graft survival and rejection with repeated human leukocyte antigen (HLA) mismatch in kidney transplantation: a retrospective multicentre cohort study protocol.

Henry Guo, William Mulley, Narelle Watson, Rhonda Holdsworth, Anne Taverniti, Jon Downing, Alycia Thornton, Lucy Sullivan, Fiona Hudson, Christopher E Davies and 5 more

Abstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Henry GuoDepartment of Nephrology, Monash Medical Centre, Clayton, VIC, Australia. henry.guo@monash.edu.
William MulleyDepartment of Nephrology, Monash Medical Centre, Clayton, VIC, Australia.
Narelle WatsonTransplantation and Immunogenetics, Australian Red Cross Lifeblood, West Melbourne, Australia.
Rhonda HoldsworthThe University of Melbourne, Melbourne, VIC, Australia.
Anne TavernitiNew South Wales Transplantation and Immunogenetics, Australian Red Cross, LifeBlood, Sydney, NSW, Australia.
Jon DowningDepartment of Clinical Immunology and PathWest, Fiona Stanley Hospital, Perth, WA, Australia.
Alycia ThorntonPathology Queensland, Brisbane, QLD, Australia.
Lucy SullivanLung Transplant Service, Department of Respiratory Medicine, Alfred Hospital and Monash University, Melbourne, VIC, Australia.
Fiona HudsonVictorian Transplantation and Immunogenetics, Australian Red Cross LifeBlood, Melbourne, VIC, Australia.
Christopher E DaviesAustralia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
Ryan GatelyDepartment of Kidney and Transplant Services, Princess Alexandra Hospital, QLD, Australia.
Armando Teixeira-PintoCentre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia.
Germaine WongCentre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia.
John KanellisDepartment of Nephrology, Monash Medical Centre, Clayton, VIC, Australia.
Wai LimDepartment of Renal Medicine and Transplantation, Sir Charles Gairdner Hospital, Perth, WA, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCandidates awaiting repeat kidney transplantation face substantial immunological barriers due to prior human leukocyte antigen (HLA) allo-sensitisation. Re-exposure to previously mismatched HLA antigens may increase the risk of acute rejection and premature graft loss. Although avoidance of repeat HLA mismatches (RMM) has been standard practice, emerging evidence suggests this risk varies according to the specific HLA allelic RMM and anti-HLA antibody profile to the RMM. Here we describe the protocol for a retrospective registry-based cohort study that aims to determine the differences in graft outcome between recipients who received kidney transplants with and without RMM, and to examine the immunogenicity of RMM that are associated with allo-sensitisation.

methodsUsing linked data between the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) and Australian organ waitlisting and matching system (2012-2023), we will evaluate the association between Class I and II HLA RMM and the risk of acute rejection and graft loss using Cox regression and competing risk models in recipients who have received repeat kidney transplants in Australia. Epitope analysis of each RMM will be examined. DISCUSSION: This study will improve understanding of the impact of RMM on kidney transplant outcomes and identify higher immunological risk RMM associated with poorer graft outcomes.

Indexed as

Graft RejectionGraft SurvivalHLA AntigensKidney TransplantationAustraliaCohort StudiesFemaleHistocompatibility TestingHumansMaleMulticenter Studies as TopicNew ZealandObservational Studies as TopicRegistriesRetrospective StudiesHLA AntigensAllograftAntibody-mediated rejectionEpletGraft lossHLA mismatchRejectionRenal transplantation

Identifiers

PMID42304306
PMCPMC13528154

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.