HLA amino acid residue matching in 2575 kidney transplants

Donor-recipient HLA matching was retrospectively evaluated in 2575 renal transplants by comparing amino acid residue matches (Res M) with conventional six-antigen matches (Ag M). Only 6% of donor-recipient combinations had 0 to 1 mismatches using Ag M, whereas 42.8% of the recipients had no mismatch by Res M. Compared with the first year results of residue mismatched recipients, the 1102 patients with 0 residue mismatching displayed a low incidence of rejection (12.07% vs 5.37%) and less anti-HLA antibody production (class I 13.76 vs 38.12%; class II 7.66% vs 31.11%). The 1-to 10-year graft survival of the residue-matched group was similar to that of the Ag-matched group, and significantly better than the residue-mismatched recipients. In summary, Res M could be a good matching system for renal transplantation in the Han population.