The influence of HLA-DR match on cadaveric renal graft survival. Experience from Stockholm.
The influence of HLA-DR match on graft and patient survival was analyzed in 124 cadaveric kidney transplant recipients treated between January 1977 and September 1980. The material consisted of 90 primary transplant and 34 retransplants. The mean patient age was 49 years, 72 were males and 52 females. Eighteen of the recipients were diabetics. Sera against the HLA-DR antigens 1-5, 7 and DRw8 were available, for DRS only during the later half of the period. When the case material was divided according to the number of donor-recipient HLA-DR antigens shared, a significant improvement in graft survival was found if one antigen was shared as compared to none shared. When 2 antigens were shared graft survival was excellent but there were only 7 such cases. When division was performed according to the number of existing HLA-DR incompatibilities, a significant improvement in graft survival was noted when there were no incompatibilities as compared with 2 incompatibilities. The distribution of foreign HLA-A, B antigens was even between the DR match groups and did therefore not constitute a bias. We conclude that matching for the HLA-DR antigens has a major beneficial effect on cadaveric kidney graft survival.
D000206:Actuarial Analysis; D000818:Animals; D002102:Cadaver; D005260:Female; D005802:Genes, MHC Class II; D006085:Graft Survival; D006684:HLA-DR Antigens; D006648:Histocompatibility; D000949:Histocompatibility Antigens Class II / Q000032:analysis* / Q000276:immunology*; D006650:Histocompatibility Testing / Q000379:methods; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011817:Rabbits; D013548:Sweden
D006684:HLA-DR Antigens; D000949:Histocompatibility Antigens Class II