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Glutathione S-Transferase M1 Gene Polymorphism Is Associated with Susceptibility to Impaired Long-term Allograft Outcomes in Renal Transplant Recipients

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Abstract

Background

Despite improved post-transplantation care, progress in long-term kidney allograft survival of diabetic renal transplant recipients (pre-DM RTR) is worse than that of non-diabetic recipients (non-DM). We hypothesized that there are other potential risk factors, that predispose RTR to adverse renal allograft outcomes.

Methods

A total of 323 transplant recipients who underwent renal transplantation between March 2000 and January 2008 were recruited. The composite end-point consisted of serum creatinine (SCr) doubling, graft failure, and death. Baseline clinical data were recorded, and polymerase chain reaction-restriction fragment length polymorphism measurements of interleukin (IL)-4, IL-10, IL-23, glutathione S-transferase (GST)A1, GSTM1, and GSTP1 polymorphisms were determined. The risk factors for developing the primary outcome were analyzed among these clinical and genetic factors.

Results

Within a mean follow-up of 71.1 ± 24 months, there were 43 (13.3 %) patients with the primary outcome. Stepwise multivariate Cox regression analysis was used to determine the risk factors for the primary outcome of RTR. Renal transplant recipients who possessed the GSTM1 null genotype had a 2.2-fold risk (95 % CI: 1.10–4.40; P = 0.026) of developing the primary outcome. Additionally, RTR that had DM before transplantation (aHR: 3.31; 95 % CI: 1.77–6.20; P = 0.0002) or changes in SCr 6 to 12 months after transplantation (aHR: 2.83; 95 % CI: 1.29–6.19; P = 0.0095) had an increased risk of developing the primary outcome.

Conclusions

In addition to the adverse role played by DM, the GSTM1 null genotype also has an unfavorable influence on the long-term allograft outcome of RTR.

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Authors and Affiliations

  1. Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan

    Horng-Rong Chang, Jen-Pi Tsai & Shun-Fa Yang

  2. Division of Nephrology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan

    Horng-Rong Chang, Chih-Kuang Lin & Jong-Da Lian

  3. Department of Nephrology, Buddhist Dalin Tzu Chi General Hospital, No 2, Mingsheng Road, Dalin Township, Chiayi County, 622, Taiwan

    Jen-Pi Tsai

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  1. Horng-Rong Chang
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  2. Jen-Pi Tsai
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  4. Chih-Kuang Lin
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  5. Jong-Da Lian
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Correspondence to Jen-Pi Tsai.

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Chang, HR., Tsai, JP., Yang, SF. et al. Glutathione S-Transferase M1 Gene Polymorphism Is Associated with Susceptibility to Impaired Long-term Allograft Outcomes in Renal Transplant Recipients. World J Surg 37, 466–472 (2013). https://doi.org/10.1007/s00268-012-1815-6

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