HLA matching: maximizing the number of compatible transplants.
1. Less than 10% of the cadaver kidneys currently allocated have 0-B,DR mismatches. 2. Up to 15% of the kidneys could be regionally allocated using the UNOS algorithm to 0-B,DR-mismatched recipients with a projected 67% 5-year graft survival. 3. Twice the number (32%) of recipients can be identified with zero of 10 A,B residues mismatched with the same 67% 5-year survival. 4. Another doubling (68%) of compatible recipients can be identified with zero of 7 DR supertypic determinants (4 DQ and 3 DRB) and zero of the A,B residues mismatched with a 66% 5-year graft survival. 5. Compressing A,B, and DR antigens to supertypic determinants reduces the racial differences in HLA to the point that 90% of kidneys can be allocated to Black recipients with zero of 3 DRB and zero A,B residues mismatched.
Takemoto
S
S
Gjertson
D W
DW
Terasaki
P I
PI
D044383:Black People; D006085:Graft Survival; D006680:HLA Antigens / Q000032:analysis*; D015276:Health Care Rationing; D006650:Histocompatibility Testing / Q000379:methods; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology* / Q000706:statistics & numerical data; D012086:Reoperation; D015996:Survival Rate; D014019:Tissue Donors; D044465:White People
D006680:HLA Antigens