Tissue attenuates to injury by the effects of heme oxygenase (HO)-1. The induction of HO-1 expression is modulated by a (GT)n dinucleotide polymorphism in the promoter of the gene, of which increased activity is associated with short (S) (≤27) repeats. We investigated the influence of this HO-1 gene polymorphism on renal transplant survival. DNA from 387 recipients and 384 donors was genotyped and we divided the HO-1 alleles into two subclasses, the S (≤27 repeats) class and long (L) class (>27 repeats). Graft survival was associated with donor and not with recipient HO-1 gene polymorphism (log rank p = 0.005; hazard ratio 0.51, 95% CI 0.32-0.83). The beneficial effect of the donor HO-1 genotype was observed in grafts exposed to prolonged cold ischemia time and acute rejection. Patients who received a kidney from L-homozygotes lost their graft significantly more often to chronic allograft nephropathy (CAN) than carriers of S-alleles (p = 0.015). Multivariate analysis showed reduced risk for graft failure in kidneys with S-alleles in comparison to L-homozygotes (odds ratio 0.50, 95% CI 0.27-0.93, p = 0.03). Kidneys that are carriers of HO-1 S-allele are less vulnerable to tissue injury resulting in less CAN and better graft survival.

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doi.org/10.1111/j.1600-6143.2004.00420.x, hdl.handle.net/1765/65045
American Journal of Transplantation
Department of Internal Medicine

Baan, C., Peeters, A., Lemos, F., Uitterlinden, A., Doxiadis, I., Claas, F., … Weimar, W. (2004). Fundamental Role for HO-1 in the Self-Protection of Renal Allografts. American Journal of Transplantation, 4(5), 811–818. doi:10.1111/j.1600-6143.2004.00420.x