Influence of HLA matching on survival of second kidney transplants in cyclosporine-treated recipients.
In an analysis of over 4000 cyclosporine-treated recipients of second kidney transplants we observed a strong effect of HLA matching in living-related and cadaver transplants. In contrast to the results obtained in first cadaver transplants, second cadaver transplants benefited substantially from matching for HLA-A locus antigens. The strongest effect of matching was found when HLA-A, HLA-B, and HLA-DR antigens were analyzed together: 214 second grafts with no mismatch had a survival rate of 82 +/- 3% at two years in contrast to a 49 +/- 4% rate in 149 grafts with 6 mismatches (P less than 0.0001, log rank). Patients whose first graft functioned for more than 1 year had a significantly higher second graft survival rate than patients with shorter first graft duration. Because the effect of HLA matching is particularly strong in patients with less than 1 year first graft duration, it is suggested that HLA well-matched kidneys should be allocated to them with priority.
Opelz
G
G
Department of Transplantation Immunology, University of Heidelberg, Federal Republic of Germany.
D003524:Cyclosporins / Q000627:therapeutic use*; D006085:Graft Survival; D006680:HLA Antigens / Q000032:analysis*; D006684:HLA-DR Antigens / Q000032:analysis*; D006801:Humans; D016030:Kidney Transplantation
D003524:Cyclosporins; D006680:HLA Antigens; D006684:HLA-DR Antigens