title: Effect of HLA matching in simultaneous pancreas-kidney transplantation.
abstract: Simultaneous pancreas-kidney (SPK) transplantation has become the therapy of choice for type 1 diabetic patients with end-stage renal disease. The current analysis examined the impact of HLA matching on graft outcome following SPK transplantation. The study population was obtained from patients enrolled in the Euro-SPK 001 study.
  
  
  METHODS
  The effect of HLA matching on graft function and survival was assessed in 180 SPK recipients in whom complete donor-recipient HLA data were available. A group of 45 patients with 0 to 3 HLA mismatches (MM) was compared to 135 patients with 4 to 6 MM.
  
  
  RESULTS
  There were no differences in 3-year kidney, pancreas, or patient survival rates between the 0 to 3 and 4 to 6 MM groups. Biological parameters of kidney and pancreas graft function were similar in both groups. Significantly more patients with 0 to 3 MM (66%) were rejection free at 3 years than those with 4 to 6 MM (41%; P = .003). The relative risk of acute rejection was 2.6 times higher among patients with 4 to 6 MM than among those with 0 to 3 MM. In conclusion, there was no evidence that HLA matching was associated with improved kidney or pancreas survival. However, a higher rate of acute rejection was observed with poor HLA matches, which may impact long-term survival.
authors.affiliation: EUROSPK Central Office, Brussels, Belgium. jacques.malaise@chir.ucl.ac.be
authors.forename: J
authors.initials: J
authors.lastname: Malaise
authors.forename: T
authors.initials: T
authors.lastname: Berney
authors.forename: P
authors.initials: P
authors.lastname: Morel
authors.forename: C
authors.initials: C
authors.lastname: Toso
authors.forename: S
authors.initials: S
authors.lastname: Demuylder-Mischler
authors.forename: P
authors.initials: P
authors.lastname: Majno
authors.forename: L
authors.initials: L
authors.lastname: Bühler
authors.forename: G
authors.initials: G
authors.lastname: Mentha
authors.forename: D
authors.initials: D
authors.lastname: Van Ophem
authors.forename: J P
authors.initials: JP
authors.lastname: Squifflet
mesh_terms: D005500:Follow-Up Studies; D006085:Graft Survival; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology* / Q000401:mortality; D016035:Pancreas Transplantation / Q000276:immunology* / Q000401:mortality; D016019:Survival Analysis