Is repeated mismatching at regrafting deleterious?
We reviewed our clinical experience of allowing kidney regrafting with a repeated HLA mismatch. We also permitted a weakly positive B-cell cross-match. All patients who received a second or subsequent renal graft (n = 92) between January 1985 and June 1990 were analysed for graft survival. The overall 1-year graft survival was 70%. A repeated mismatch occurred in 29 of the patients at at least one HLA locus and their 1-year graft survival was 66%. The balance of the regrafts (63) were performed without a repeated mismatch, and their 1-year graft survival was 70%. Even a weakly positive B-cell cross-match was deleterious; when a grafting with a repeated mismatch was performed only one out of five grafts survived. Our results indicate that retransplantation of renal grafts with a repeated mismatch in the HLA A or B locus can be performed without a negative influence on transplant outcome provided that both the T- and B-cell cross-matches are negative.
Tufveson
G
G
Department of Surgery (Transplantation Unit), University Hospital, Uppsala, Sweden.
Bengtsson
M
M
Bergström
C
C
Frödin
L
L
Lewén
G
G
Sjöberg
O
O
Skarp
I
I
Tötterman
T
T
Wahlberg
J
J
Wikström
B
B
D006085:Graft Survival / Q000502:physiology*; D006650:Histocompatibility Testing / Q000592:standards*; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000941:ethics; D016896:Treatment Outcome