Analysis of HLA-DR split-specificity matching in cadaver kidney transplantation: a report of the Collaborative Transplant Study.
The influence of mismatches for HLA-DR "split" specificities was investigated in more than 8000 cadaver kidney transplants. HLA-DR typing was performed using DNA methodology. Among first transplants, mismatches defined by HLA-DR split specificities did not have a deleterious influence. Among retransplants, however, graft survival was significantly decreased if a mismatch was defined, considering split specificities in patients with no mismatch according to the "broad" definition (P=0.04) and also in grafts with two split mismatches, which showed only one mismatch according to the broad definition (P=0.03). Moreover, consideration of further "subsplit" specificities resulted in clinically relevant mismatches only among retransplants. These data indicate that the recognition of HLA-DR split specificity mismatches is fundamentally different in primary and regraft recipients. The results imply that recipients and donors of kidney retransplants should be typed for HLA-DR split specificities and that these specificities should be considered for organ allocation.
Opelz
G
G
Department of Transplantation Immunology, Institute of Immunology, University of Heidelberg, Germany.
Scherer
S
S
Mytilineos
J
J
D000483:Alleles; D002102:Cadaver; D006684:HLA-DR Antigens / Q000235:genetics / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation
D006684:HLA-DR Antigens