title: Low kidney graft survival in Lewis negative patients after regrafting and newer matching schemes for Lewis.
abstract: Le-cadaver donor kidney transplant recipients regrafted had a 1-year graft survival rate of 0%. This was statistically significantly lower than survival rates in Lea or Leb patients of 60% and 64%, respectively, at 1 year (P = .01 and P = .009). We conclude that if Le- patients had rejected an Le+ graft, a repeated incompatibility should be avoided since the recipients had already demonstrated immunoreactivity against this epitope. Recipients being confronted with an Le group mismatch in the first graft often have successful grafts and the difference in 1-year graft survival of Lea (75%), Leb (76%), and Le- (68%) patients was not statistically significant different. We suggest that the matching scheme for the Le groups be reevaluated. The older method of matching on the basis of Le+ and Le- is probably no longer justified. According to chemical structure, it would appear that Leb should be a universal recipient and Lec a universal donor. This scheme, however, has failed to correspond to interracial transplants between whites and blacks. A matching scheme that requires identity between donor and recipient showed a remarkable correlation with the results between black-to-black, black-to-white, white-to-black and white-to-white transplants.
mesh_terms: D001787:Blood Group Incompatibility / Q000276:immunology*; D000939:Epitopes; D005006:Ethnicity; D006085:Graft Survival; D006801:Humans; D007114:Immunization; D016030:Kidney Transplantation; D007983:Lewis Blood Group Antigens / Q000276:immunology*
chemical_list: D000939:Epitopes; D007983:Lewis Blood Group Antigens