Comparison of blood group versus HLA-dependent transplantation and its influence on donor kidney survival.
BACKGROUND
The advantages of organ allocation based on human leukocyte antigen (HLA) typing are controversial. This evaluation compares the results of HLA-dependent and non-HLA-dependent allocation in the transplantation of donor kidneys.


METHODS
Seventy-seven donor kidney pairs explanted locally between 1984 and 1994 were examined. One half of each pair was transplanted locally in Bonn on the basis of criteria including blood group, waiting time and currently negative cross-match. The other half of these pairs was allocated in accordance with the Eurotransplant (ET) criteria.


RESULTS
Cold ischaemia time was an average of 14.02 h in Bonn vs. 24.18 h in the ET group (P<0.0001). The number of HLA mismatches was calculated and, for example, for locus A it was 1.13 in Bonn vs. 0.73 in the ET group (P=0.0003). One-year graft survival for the locally transplanted kidneys was 92.2% and, for the ET kidneys, 90.9%. Five-year survival was 79.5% vs. 81.7%, respectively. Patient survival after 1 year was 100% vs. 97.4%, and after 5 years, 93.4% vs. 93.1%.


CONCLUSIONS
The results show that it is possible to provide patients with a locally allocated kidney graft that enables good function after a short waiting period. This procedure avoids long cold ischaemia time and long waiting periods.
Gillich
Markus S
MS
Department of Urology, University of Bonn, Bonn, Germany. MGillich@t-online.de
Heimbach
Dirk
D
Schoeneich
Georg
G
Müller
Stefan C
SC
Klehr
Hans Ulrich
HU
D000328:Adult; D001789:Blood Group Antigens; D005260:Female; D006085:Graft Survival; D006680:HLA Antigens / Q000032:analysis*; D006650:Histocompatibility Testing; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D016030:Kidney Transplantation; D008297:Male; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors
D001789:Blood Group Antigens; D006680:HLA Antigens