HLA matching at a single kidney transplant center.
Over 1000 patients were analyzed in two different time intervals, 1978-1983 and 1984-1989; these corresponded to patient groups not treated with cyclosporine and treated with cyclosporine. Analysis of mismatching showed that there was a significant (P less than 0.05) longterm matching effect in the precyclosporine, era with 0 HLA-DR-mismatched recipients having a 9.5-year half-life compared with a 3-year half-life for the 2 HLA-DR-mismatched transplant recipients. The trend was similar for the cyclosporine-treated groups, but not significant. Risk factors for donor age and race of the recipient (P less than 0.05) were identified in the cyclosporine-treated group. Graft survival in the high-risk patient populations was 70% or better in the 0, 1 HLA-ABDR-mismatched groups as compared with less than 60% graft survival in the high-risk transplant recipients with 2-6 HLA-ABDR mismatches. In the cyclosporine era the HLA-ABDR 0, 1-mismatched patient groups showed a significantly better graft survival than was found in all other categories and at all time intervals analyzed. Matching is a way to ameliorate some of the high risk potential associated with less than optimal donor or recipients.
Mendez
R
R
Renal Transplant Service, St. Vincent Medical Center, Los Angeles, California 90057.
Cicciarelli
J
J
Mendez
R G
RG
Boken
R
R
Meihaus
J
J
Bogaard
T
T
Chaballout
A
A
D000367:Age Factors; D003524:Cyclosporins / Q000627:therapeutic use; D006085:Graft Survival; D006684:HLA-DR Antigens / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D044469:Racial Groups; D012307:Risk Factors
D003524:Cyclosporins; D006684:HLA-DR Antigens