Influence of polymorphisms in the vascular endothelial growth factor gene on allograft rejection after kidney transplantation: a meta-analysis

<p><span><b><i>Purpose</i></b><i> </i>Reported associations of allograft rejection in kidney transplant patients with <i>VEGF</i> single nucleotide polymorphisms (SNPs) have been inconsistent between studies, which prompted a meta-analysis to obtain more precise estimates.</span></p> <p><span><b><i>Methods</i></b><i> </i>Using the PICO elements, kidney transplant patients (P) were compared by genotype data between rejectors (I) and non-rejectors (C) in order to determine the risk of allograft rejection (O) attributed to the <i>VEGF</i> SNPs. Literature search of four databases yielded seven articles. To calculate risks for allograft rejection, four SNPs were examined. Meta-analysis treatments included outlier and subgroup analyses, the latter was based on ethnicity (Indians/Caucasians) and rejection type (acute/chronic). Multiple comparisons were corrected with the Bonferroni test. </span></p> <p><span><span><b><i>Results</i></b> Five highly significant outcomes (P^a &lt; 0.01) survived Bonferroni correction, one of which showed reduced risk for the <i>var</i> allele (OR 0.61, 95% CI 0.45-0.82). The remaining four indicated increased risk for the <i>wt</i> allele where the chronic rejection (OR 2.10, 95% CI 1.36-3.24) and Indian (OR 1.44, 95% CI 1.13-1.84) subgroups were accorded susceptibility status. </span></span></p> <p><span><b><i>Conclusions</i></b> Risk associations for renal allograft rejection were increased and reduced on account of the <i>wt</i> and <i>var</i> alleles, respectively. These findings could render the <i>VEGF</i> polymorphisms useful in the clinical genetics of kidney transplantation. </span></p>