[HLA-amino acid residue matching in organ transplantation]

To present a new matching policy-HLA amino acid residue matching (Res M) for Chinese population.

Based on the outcome of genotyping for HLA alleles in massive samples, we presented new Res M according to 10 groups of amino acid residue for class I and, groups of DR/DQ for class II and compared them with HLA six-antigen match program (Ag M). The influence of Res M on early renal function, acute rejection and 1-5 year graft survivals were retrospectively analyzed in 316 cases of first cadaver kidney transplantation.

The rate of Res-matched transplants increased greatly. The rate of 0 mismatch (MM) recipients increased from 0.3% by Ag M to 10% by Res M, and that of 0-1 MM transplants from 3.2% to 42.4%. Clinical study showed that 1 - 5 year graft survival with 0 - 1 Res-MM was similar to kidneys with 0 - 2 Ag-MM. Compared to 3 - 4 Res-MM, the early renal function obviously improved (88.8% vs 46.7%), acute rejection decreased (14.9% vs 86.9%), 1 - 5 year survival was increased by 10% - 26% (P < 0.05), and graft survival increased by 14% - 35% (P < 0.01) in recipients with 0 - 1 Res-MM. Cox regression showed that in 10 factors affecting the graft survival, Res-MM was most significant (risk ratio 21.73).

New Res M has proved to be suitable for clinical application in Chinese population, especially for cadaver kidney transplantation.