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Introduction It has recently been proposed to replace the current Eurotransplant kidney allocation based primarily on mismatches (MM) at the 3 HLA loci by a simpler system based on full HLA-DR compatibility. The present study analyzes this system in the current era of immunosuppression. Methods From 1999 to 2012, 723 renal grafts were performed on 586 patients who were treated with a calcineurin inhibitor, mycophenolate mofetil, and in most cases antilymphocyte globulins. Four groups of HLA MM were compared: (A) A+B 2-4/DR 1-2 MM (n = 397), (B) A+B 2-4 MM/DR 0 MM (n = 106), (C) A+B 0-1 MM/DR 1-2 MM (n = 138), and (D) A+B 0-1/DR 0 MM (n = 82). Results Acute rejection episodes were less frequent during the first post-transplantation year in group D than in the other groups ( P = .018). Patient survival was lower in group A than in the other groups ( P = .008). Immunologic graft survival was higher in group D than in the other groups in univariate ( P = .015) and multivariate analyses ( P = .033; 96.4% vs 90.1% at 10 years). Conclusions In the current era of immunosuppression, allocation of kidneys from deceased donors could be performed primarily according to full DR compatibility then to the best A+B matching, affording excellent graft outcome to most recipients. [ABSTRACT FROM AUTHOR]

An abstract of the paper "Immunogenicity of the PandemRIX A (H1N1) 2009 Influenza vaccine in hemodialysed and renal transplanted patients," by A. Hombrouck and colleagues is presented.

Abstract: Background: The incidence of new-onset posttransplant diabetes mellitus (PTDM) is increased in renal transplant patients treated with tacrolimus. Methods: We retrospectively analyzed fasting plasma glucose and HbA1c levels as well as the dose of glucose-lowering agents in 34 renal transplant patients converted from tacrolimus to cyclosporine (CsA) for PTDM. Diabetes was defined according to current guidelines as repeated fasting plasma glucose (FPG) levels ≥126 mg/dL. Results: At conversion, 11 patients received insulin, 5 received oral agents, and 18 had no glucose-lowering therapy. Fasting plasma glucose levels decreased from 146 ± 64 mg/dL at conversion to 111 ± 26 mg/dL at 3 months and 104 ± 21 mg/dL at 12 months (P < .001). HbA1c levels decreased from 6.8 ± 0.8% at conversion to 6.0 ± 0.6% at 12 months (P = .001). Insulin was stopped in 3, the dose reduced in 7, and remained stable in 1 of the patients. The average daily insulin dose among these patients was reduced from 31 ± 17 units at conversion to 13 ± 12 units at 12 months (P < .05). There was no significant change in the number of patients treated with oral glucose-lowering agents. Diabetes reversed (fasting plasma glucose ≤ 125 mg/dL without glucose-lowering therapy) in 44% (95% confidence interval, 23% to 64%) of patients during the first year after conversion (P < .001). Graft function, blood pressure, and lipid levels remained stable after conversion but the proportion of patients receiving lipid-lowering therapy increased from 18% to 49% (P < .01). Conclusions: Conversion from tacrolimus to CsA for PTDM was associated with a marked improvement in glucose metabolism and frequent reversal of diabetes. [Copyright &y& Elsevier]