Long-term graft survival rate of zero-mismatch kidney transplants for HLA-DRB1.
The study of a two-locus association between HLA-B and -DRB 1 revealed a significant 43 linkage disequilibrium. Donor-recipient HLA-DRB1 was determined by these 43 linkages. Zero-mismatch for HLA-DRB1 had a significant effect on the graft survival rate in living related and cadaver transplants. The 5-year graft survival rate was 94% in the zero-mismatch group for HLA-DRB1, 96% for related transplants, 92% for cadaver cases, and 94% in HLA identical siblings. A statistically significant difference was found between the zero-mismatch group for HLA-DRB1 and mismatch groups for HLA-DRB1 or HLA-DR (P < 0.01). The zero-mismatch group for HLA-DRB1 had mismatches for HLA-A and/or HLA-B in 46 of 70 cases (66%). No significant differences in the rejection rate was observed between zero-mismatch and mismatch cases for HLA-A and/or -B in the zero-mismatch group for HLA-DRB1. In the second step, genotyping was conducted in 118 cases. The 5-year graft survival rate was 93% in the zero-mismatch group for HLA-DRB1 and 86% in mismatch group (not a significant difference). We concluded that zero-mismatch transplant for HLA-DRB1 had a better long-term graft survival rate regardless of HLA class I.
Department of Urology and Kidney Transplant Center, Hyogo Prefectural Nishinomiya Hospital, Japan.
Y
Y
Ichikawa
N
N
Fujimoto
M
M
Hashimoto
M
M
Kyo
T
T
Kinoshita
S
S
Takahara
M
M
Yamasaki
S
S
Ohshima
H
H
Ihara
T
T
Fukunishi
M
M
Sata
H P
HP
Amemiya
T
T
Hanafusa
S
S
Nagano
D016572:Cyclosporine / Q000627:therapeutic use; D005500:Follow-Up Studies; D006085:Graft Survival / Q000276:immunology*; D015235:HLA-B Antigens / Q000235:genetics / Q000276:immunology; D006684:HLA-DR Antigens / Q000235:genetics / Q000276:immunology*; D059811:HLA-DRB1 Chains; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology*; D015810:Linkage Disequilibrium; D009679:Nuclear Family; D012189:Retrospective Studies; D017741:Survivors; D013997:Time Factors
D015235:HLA-B Antigens; D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains; D007166:Immunosuppressive Agents; D016572:Cyclosporine