World Journal of Surgery

, Volume 37, Issue 2, pp 466–472 | Cite as

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

  • Horng-Rong Chang
  • Jen-Pi TsaiEmail author
  • Shun-Fa Yang
  • Chih-Kuang Lin
  • Jong-Da Lian



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.


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.


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.


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.


Single Nucleotide Polymorphism Renal Transplant Recipient GSTM1 Null Genotype Primary Composite Outcome Chronic Allograft Dysfunction 
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Conflict of interest

There is no conflict of interest of this article.


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Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  • Horng-Rong Chang
    • 1
    • 2
  • Jen-Pi Tsai
    • 1
    • 3
    Email author
  • Shun-Fa Yang
    • 1
  • Chih-Kuang Lin
    • 2
  • Jong-Da Lian
    • 2
  1. 1.Institute of MedicineChung Shan Medical UniversityTaichungTaiwan
  2. 2.Division of Nephrology, Department of Internal MedicineChung Shan Medical University HospitalTaichungTaiwan
  3. 3.Department of NephrologyBuddhist Dalin Tzu Chi General HospitalDalin TownshipTaiwan

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