title: Increasing the chance to accept HLA-ABDR mismatched donor in kidney transplantation.
abstract: Two hundred and fifty-three kidney transplantations (KT) which included 68 (26.9%) living-related (L) and 185 (73.1%) cadaveric (C) KT with 0-6 HLA-ABDR mismatches (MM) were studied for the association of HLA-ABDR-MM specificities and the occurrence of graft rejection (GR). It was found that the incidence of acute and chronic rejection in CKT was significantly higher than that of LKT (42.1% vs 22.1%, p < 0.005). It was also observed that the number of ABDR-MM, AB-MM and BDR-MM which is important in GR were 2 times in CKT compared with LKT. The analysis revealed that HLA-A11, B16, B22, B35, B5, B17 and DR3 were good responders, whereas, HLA-A30, A2, B62, B18, B40, B44, B46 and DR10 were good stimulators for KT. GR were significantly increased with p < 0.01 and < 0.05, respectively. Specific HLA-MM specificities played a significant role in GR, i.e., some HLA-MM specificities were permissible, whereas, some were immunogenic. Careful selection of donor and recipient for KT by avoiding immunogenic HLA-MM and/or accepting permissible HLA-MM will improve graft survival and reduce the demand of kidney for retransplantation.
authors.affiliation: Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: K
authors.initials: K
authors.lastname: Sujirachato
authors.forename: P
authors.initials: P
authors.lastname: Chiewsilp
authors.forename: T
authors.initials: T
authors.lastname: Mongkolsuk
authors.forename: S
authors.initials: S
authors.lastname: Junpong
authors.forename: V
authors.initials: V
authors.lastname: Sumethkul
authors.forename: S
authors.initials: S
authors.lastname: Jirasiritham
authors.forename: S
authors.initials: S
authors.lastname: Sriphojanart
authors.forename: S
authors.initials: S
authors.lastname: Kanjanapanjapol
authors.forename: S
authors.initials: S
authors.lastname: Domrongkitchaiporn
mesh_terms: D000483:Alleles; D002102:Cadaver; D016009:Chi-Square Distribution; D006084:Graft Rejection / Q000453:epidemiology / Q000276:immunology*; D006085:Graft Survival / Q000276:immunology; D006680:HLA Antigens / Q000032:analysis*; D006239:Haplotypes; D006650:Histocompatibility Testing; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000276:immunology*; D012189:Retrospective Studies; D013785:Thailand / Q000453:epidemiology
chemical_list: D006680:HLA Antigens