Evidence map›Paper›PMID 42638165›Full record

ArticleClinical transplantation2026

HLA-A, -B, and DR Mismatch and Outcomes After Simultaneous Pancreas-Kidney Transplantation in the Modern Era.

Moksh Sachdeva, Samuel Tingle, Georgios Kourounis, Abdullah Malik, Emily Thompson, Steve White, Neil S Sheerin, Colin Wilson

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

8 authors.

Moksh SachdevaTranslational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK.
Samuel TingleTranslational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK.
Georgios KourounisTranslational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK.
Abdullah MalikTranslational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK.
Emily ThompsonTranslational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK.
Steve WhiteTranslational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK.
Neil S SheerinTranslational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK.
Colin WilsonTranslational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK.

Funding

Kidney Research UKMedical Research Council Clinical Research Training Fellowship MRC/Y000676/1National Institute for Health and Care Research (NIHR) Blood and Transplant Research UnitOrgan Donation and Transplantation NIHR203332
6 · The paper itself

Abstract

backgroundHLA mismatch is known to impact post-transplant outcomes following kidney-alone transplantation. However, the impact on kidney outcomes in the context of simultaneous pancreas-kidney (SPK) transplantation remains uncertain. This study aimed to assess the impact of HLA mismatch on SPK outcomes.

methodAdult SPK recipients in the UNOS STAR registry (2010-2023) were analysed. Re-transplants were excluded. Multivariable nonlinear regression models evaluated the impact of HLA mismatch on outcome.

resultsIn a cohort of 10,559 SPK recipients overall mismatch was frequent, with only 34 recipients (0.3%) having 0/0/0 mismatches across HLA-A, HLA-B, and HLA-DR. HLA-DR mismatch was not associated with pancreas or kidney graft survival at 5 years; two versus zero HLA-DR mismatches aHR = 1.015 (95% CI 0.828-1.243) for pancreas graft survival, and aHR = 0.946 (0.753-1.188) for kidney graft survival. HLA-DR mismatch was also not associated with pancreas or kidney acute rejection or 12-month eGFR. HLA-A and HLA-B mismatches also showed no association with any pancreas or kidney transplant outcomes. Three-way interaction analyses between HLA-A, B and DR demonstrated no evidence that mismatch at any locus affected outcomes, irrespective of mismatch level at the other loci.

conclusionIn first-time simultaneous pancreas-kidney transplantation, donor-recipient HLA mismatch was not associated with pancreas or kidney graft survival, rejection, or early renal function. These findings contrast with kidney-alone transplantation and suggest that classical HLA mismatch effects may be attenuated in the contemporary SPK setting. Prioritising HLA-based matching, including HLA-DR, is therefore unlikely to improve short- or medium-term post-transplant outcomes in first-time SPK transplantation.

Indexed as

Graft RejectionHistocompatibilityHLA-A AntigensHLA-B AntigensHLA-DR AntigensKidney Failure, ChronicKidney TransplantationPancreas TransplantationPostoperative ComplicationsAdultFemaleFollow-Up StudiesGlomerular Filtration RateGraft SurvivalHistocompatibility TestingHumansHLA-A AntigensHLA-B AntigensHLA-DR Antigens

Identifiers

PMID42638165
PMCPMC13503977

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.