HLA matching: a comparison of conventional and molecular approaches.
1. The UNOS national sharing program has produced a 5-fold increase in the number of compatible transplants since 1987. 2. Transplants with 0 broad HLA-antigen mismatches had 87% 1-year graft survival and an 18-year half-life, essentially the same result as with conventional matching. 3. Equally impressive results were obtained with public determinant matching: 1-year graft survival ranging from 84 to 88% and a half-life of 12-15 years. 4. Increasing the number of matched determinants improved the results but reduced the number of compatible recipients identified. 5. Less than 10% of the current transplants have 0 public determinants mismatched. This fraction could be increased to 66% with local sharing and to over 90% with national sharing. 6. The results for cadaver transplants would approach those of related kidneys if compatible grafts were transplanted at the 90% rate obtainable with molecular matching.
Takemoto
S
S
Gjertson
D W
DW
Terasaki
P I
PI
D002102:Cadaver; D003429:Cross Reactions; D000939:Epitopes / Q000235:genetics; D006085:Graft Survival; D006680:HLA Antigens / Q000145:classification / Q000235:genetics; D006650:Histocompatibility Testing / Q000379:methods*; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology* / Q000401:mortality / Q000706:statistics & numerical data; D011110:Polymorphism, Genetic; D012042:Registries; D015996:Survival Rate; D014481:United States / Q000453:epidemiology
D000939:Epitopes; D006680:HLA Antigens