The impact of center variation on the HLA-DR matching effect in kidney graft survival.
Data from 7436 cases of first-cadaver transplants between 1981 and 1986 from 50 transplant follow-up centers within Eurotransplant, were analyzed with respect to the effect of HLA-DR matching on graft prognosis within the first year posttransplant. The use of cyclosporine was allowed for as well as the variation in graft survival rate between transplant follow-up centers. After adjustment for these variables, HLA-DR matching was still very significant. The effect of CsA on graft survival varied between centers--i.e., interaction was observed--but the effect of HLA-DR mismatching did not vary significantly between centers. Over all the centers there was a 1.4-fold increase in relative risk for each increase in HLA-DR mismatch, corresponding to predicted one-year graft survivals of 86.5%, 81.9%, and 75.4% for 0, 1, and 2 HLA-DR mismatches respectively, in patients receiving CsA, and 72.5%, 64.2%, and 53.6% in patients not receiving CsA.
Thorogood
J
J
Eurotransplant Foundation, Leiden University, The Netherlands.
van Houwelingen
J C
JC
van Rood
J J
JJ
Persijn
G G
GG
D003524:Cyclosporins / Q000627:therapeutic use*; D005060:Europe; D006085:Graft Survival; D006684:HLA-DR Antigens / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation; D015337:Multicenter Studies as Topic; D011379:Prognosis
D003524:Cyclosporins; D006684:HLA-DR Antigens