Effect of HLA matching in simultaneous pancreas-kidney transplantation.
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.
Malaise
J
J
EUROSPK Central Office, Brussels, Belgium. jacques.malaise@chir.ucl.ac.be
Berney
T
T
Morel
P
P
Toso
C
C
Demuylder-Mischler
S
S
Majno
P
P
Bühler
L
L
Mentha
G
G
Van Ophem
D
D
Squifflet
J P
JP
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