Benefits of HLA-A and HLA-B Matching on Graft and Patient Outcome after Cadaveric-Donor Renal Transplantation

Abstract

Data collected prospectively on 3811 renal transplantations performed between June 1977 and July 1982 by the 42 member institutions of the South-Eastern Organ Procurement Foundation were analyzed to determine the influence of donor-recipient HLA-A and HLA-B matching on patient and graft outcome. Well-matched recipients were more likely to have received kidneys from outside their own centers, were more highly presensitized, included fewer blacks, and were more likely to have lost an earlier graft. Multivariate Cox regression analysis that included these and six other potential confounding variables revealed a significant association (P less than 0.001) between good HLA-A and B matching and increased graft survival. The difference in mean (+/- S.E.) actuarial graft survival between recipients worst matched and best matched for HLA-A and B antigens increased with time: 55 +/- 2 per cent as compared with 64 +/- 4 per cent at six months and 18 +/- 4 per cent as compared with 44 +/- 7 per cent at four years. Poor HLA matching of donor with recipient provided the greatest relative risk (2.16) of irreversible graft rejection of all the variables examined. Among patients with functioning grafts, well-matched recipients had lower serum creatinine levels and received significantly smaller amounts of glucocorticoids. Our findings indicate that good HLA-A and B matching is highly dependent on a system for sharing organs among institutions, and results in decreased graft rejection, better long-term graft function, and less need for post-transplantation immunosuppression.

HLA-A, -B, -C, -DR, and -DQ Matching in Pancreas Transplantation: Effect on Graft Rejection and Survival

“…For kidney recipients, studies agree on a general trend toward improved graft survival with decreasing numbers of combined HLA-A, -B, and -DR MMs (2,4,6,27). The major impact of matching is due to the HLA-DR and -B loci, with the HLA-A locus much less significant (3,28).…”

HLA Tissue Typing Has No Effect on the Outcome of Patients Undergoing a Living-donor Liver Transplant: A Single-center Experience in Egypt

“…10 Studies performed in clinical solid organ transplants have sought to gain insight into immunologic parameters that could be important in altering the course of allograft tolerance, thus modifying the prognosis. Two main factors, donorrecipient HLA compatibility and the absence of preformed, donor-specific anti-HLA cytotoxic antibodies (giving rise to a positive crossmatch), are known to contribute to a more-favorable outcome in renal 11 and heart transplants. 12 In this study, based on studying the effect of a positive crossmatch on the outcome after liver transplant in our own patient population, it was found that both groups showed no statistical difference regarding total hospital and ICU stay, immunosuppressive use, rejection episodes, pulse steroid use, graft failure, mortality, and 5-year patient and graft survival.…”

Development of simple and rapid HLA-C genotyping method using an oligonucleotide microarray

“…Among HLAs, HLA-A, -B, -C, and DRB1 are important to transplantation [1][2][3][4][5][6][7][8] . Previous studies have shown that correct matching of this locus genotype improves the survival rate 7,9 and reduces immunological complications in graft-versus-host disease (GVHD) and graft rejection 1,10 .…”