Renal transplantation between HLA identical siblings. Comparison with transplants from HLA semi-identical related donors.
We compared 26 HLA-A, B identical sibling kidney-transplant recipients followed for one to 10 years, with 104 HLA-A, B semi-identical kidney recipients from living, related donors to determine clinical differences. Graft-survival rates were significantly better in the HLA identical group at two years (85 per cent identical versus 53 per cent in semi-identical, P less than 0.005); patient-survival rates were high for both (96 per cent in identical and 87 per cent in semi-identical at two years, P less than 0.005). The incidence of complications was similar in HLA identical and semi-identical recipients. Nine of the 26 grafts in HLA identical recipients failed one week to eight years after transplantation. Rejection caused most of the graft failures. Recipients of HLA identical-sibling kidney transplants have a high patient and graft survival, but they also encounter many complications. Immunologic rejection occurs, even with negative mixed lymphocyte culture, suggesting the importance of donor determinants other than the HLAA, B and D other than the HLA-A, B and D.
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006680:HLA Antigens; D006649:Histocompatibility Antigens; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007668:Kidney / Q000276:immunology; D016030:Kidney Transplantation; D007959:Lymphocyte Culture Test, Mixed; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013997:Time Factors; D014019:Tissue Donors; D014184:Transplantation, Homologous; D014552:Urinary Tract Infections / Q000209:etiology
D006680:HLA Antigens; D006649:Histocompatibility Antigens