Abstract

Background: Genetic background is one of the important factors which may influence rejection rate and function of the renal graft. Aim of the study was to evaluate correlation of gene's polymorphisms and the rate of rejection and renal function after transplantation.
Material/Method: On the whole, 207 transplanted patients (11±4.4 years) were evaluated. Immunosuppression protocol: CsA or TAC combined with AZA or  MMF and steroids. Acute and chronic rejection was diagnosed by the renal biopsy and/or clinical criteria. Analysis of genes for MDR1, TNF CYP3A5, IL 1, IL-1RN, IL-6, IL-10, MCP-1, TGF,and CCR5 with PCR/PCR-RFLP techniques was performed. GFR was calculated based on the Schwartz formula.
Results: Incidence of biopsy-proven episode of acute rejection was 12.1%,  re-rejection rate was 20.8%. Among patients with recurrent rejection GG G  (-174)C IL-6 polymorphism was more frequent (p=0.038) (than CC) and among patients with CAN (23.5%) (p=0.044). In patients with *3*5 IL-1RN polymorphism graft function at 6 months, 1, 2, 3, 4 years post -transplant was better (p<0.001) than in patients with other alleles.  GFR at 8 years post-transplant was better (p=0.039) in patients with G (-308) A TNF polymorphism. Other evaluated correlations were not significant.
Conclusions: Gene's polymorphisms of IL-6, IL-1RN and TNF were shown as significant factors influencing rejection rate, chronic rejection and long-term graft function after renal transplantation.

Keywords: Kidney Transplantation