No impact of cross-reactive group human leucocyte antigen class I matching on long-term kidney graft survival

The aim was to elucidate the effect of matching for the broad human leucocyte antigen (HLA)-A and -B cross-reactive groups (CREGs) of major histocompatibility complex (MHC) class I on long-term kidney graft survival.

1304 patients transplanted at Rigshospitalet between 1968 and 1999 with a cadaver kidney and followed until 2000. The definition of CREGs based on amino acid residues was according to United Network for Organ Sharing (UNOS) (1996). Graft-survival analyses (Kaplan Meier) were performed for all cases and for cases censored for death with functioning grafts.

Univariate analysis showed no effect of any specific donor or recipient CREG on graft survival. Contrary to some reports in the literature, the absolute and relative number of CREG shares and of CREG mismatches had no effect on graft survival even when censored for graft loss because of death. However, graft survival was dependent on DR shares (P < 0.05), indicating that matching for MHC class II seems to be more important than that for the broad MHC class I phenotype represented by CREG.