Short- and long-term effects of HLA matching.
1. Matching shows a positive effect, even in the CsA era. In this report we have seen that in a group of 12,886 patients (90% of whom were given CsA), when a donor and recipient had no A,B,DR mismatches, their overall survival exceeded baseline by 5% at 6 months and by a 2.5-year increase in half-life past 6 months. 2. When loci are combined, their effect on graft survival is greater than when loci are viewed individually. Differences from baseline in Figures 6-13 are greater than those in Figures 2-5. 3. Class II DR antigens show a short-term effect but relatively little long-term differences, whereas Class I antigens (A and B loci) have immaterial short-term effects but significant long-term differences. Comparisons involving DR mismatches (eg, Figures 5, 10, 11, 12) always showed significant differences in short-term survival (an average 9% increase from best to worst mismatch categories), but, when DR was studied alone (Fig. 5), small differences in half-lives between 0, 1, and 2 mismatches were noted (ie, 7.6 years vs 6.0 years). In contrast, when A and B mismatches were studied without DR (eg, Figs. 2, 3, 6-9), 6-month graft survivals were never significantly different from baseline, whereas nearly all comparisons (Figs. 2, 3, 6-12) showed significantly widening half-life differences (approximately 4 years) between best and worst mismatch.(ABSTRACT TRUNCATED AT 250 WORDS)
Gjertson
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D000328:Adult; D006085:Graft Survival; D006680:HLA Antigens; D015234:HLA-A Antigens; D015235:HLA-B Antigens; D006684:HLA-DR Antigens; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology* / Q000706:statistics & numerical data; D012042:Registries; D013997:Time Factors
D006680:HLA Antigens; D015234:HLA-A Antigens; D015235:HLA-B Antigens; D006684:HLA-DR Antigens