Comparison of serologic and biochemical definitions of HLA class I polymorphisms in cadaver renal transplantation

The role of biochemical variants in matching renal donors with recipients was investigated in a population of 26 donor recipient pairs from the period 1979-85. Serologic typing was compared with a biochemical analysis of HLA-A and -B antigens in a group in which there had been no mismatches for HLA-A and -B antigens by serology. HLA-A and -B serology was updated using stored material for 92.2% of the renal recipients and donors (n = 51), and HLA-A, -B, and -DR serology was updated for 84.3%. No inconsistencies were found with the HLA-A and -B antigens assigned at the time of transplant. HLA-A and -B antigens of 70% of the renal recipients and donors were analyzed by immunoprecipitation from lymphocytes and serum and analyzed after isoelectric focusing by autoradiography and Western blotting. No biochemical differences between recipient and donor were found for any one pair when HLA-A and -B antigens were serologically the same. This biochemical analysis was useful in providing results where there was doubt over the presence or absence of an antigen serologically. In a well-matched situation, HLA-A and -B serologic types were concordant with results obtained biochemically. However, in a poorly matched situation this could be different.