Donor or recipient TNF-A −308G/A polymorphism and acute rejection of renal allograft: A meta-analysis

BackgroundResults from published studies on the association of donor or recipient TNF-A −308G/A polymorphism with acute rejection (AR) of renal allograft are inconsistent. We performed a meta-analysis to summarize the possible association.MethodsStudies were identified by searching PUBMED, EMBASE and Chinese National Knowledge Infrastructure (CNKI) databases until March 22, 2011. Meta-analysis was performed in a fixed/random-effect model using Revman 5.0.25 and STATA10.0.ResultsEight studies evaluating the association between donor TNF-A −308G/A polymorphism and acute rejection of renal allograft were identified. Pooled OR based on 460 cases (whose recipient developed AR) and 623 controls (whose recipient did not develop AR) was 1.44 (95% CI = 1.05–1.99, p = 0.03). No association was detected in the subgroup analysis based on ethnicity. 28 studies evaluating the association between recipient TNF-A −308G/A polymorphism and acute rejection were identified. Pooled OR based on 1411 cases (patients did not develop AR) and 2088 controls was 1.39 (95% CI = 1.06–1.82, p = 0.02). Two studies evaluating the association between recipient TNF-A −308G/A polymorphism and recurrent acute rejection were identified. Pooled OR based on 225 cases (patients with ≤ 1 AR) and 34 controls (patients with ≥ 2 AR) was 0.28 (95% CI = 0.13–0.62, p = 0.002).ConclusionsOur meta-analysis provided evidence that TNF2 allele positive genotype of donor or recipient was associated with increased risk of incidence of acute rejection of renal allograft. Recipient TNF2 allele positive genotype is also associated with increased risk of recurrence of acute rejection of renal allograft. However, additional studies with large sample size and better study designs are warranted to verify our finding.

Research highlights
► We searched PUBMED, EMBASE and CNKI databases till March 22, 2011.
► 32 eligible studies were identified.
► AA/AG genotype of donor or recipient was related to incidence of acute renal allograft rejection.
► Recipient AA/AG genotype is also associated with recurrent acute renal allograft rejection.