A need to adopt new strategies for organ donation in Saudi Arabia

HLA matching in kidney transplantation is a major factor in long-term survival of the graft. In Saudi Arabia, most deceased donors are non-Saudi, making it difficult to achieve minimal HLA mismatches between donor and recipient.

To analyze HLA types of 200 deceased donors and compare them with the Saudi population's HLA types.

In a retrospective study analyzing HLA types of the last 398 deceased donors processed in a tertiary hospital in Riyadh, Saudi Arabia, HLA types of all donors were compared with HLA types from a control group of healthy Saudi persons.

HLA types were significantly different between the deceased donor group and the Saudi population. In all deceased donors, zero mismatches was never achieved. The major differences in HLA types were in HLA-A*02, HLA-B*15, B*40, B*50, HLA-DRB1*14, DRB1*15, and DRB1*04.

As most of our deceased donors are non-Saudis, it is difficult to match for HLA-A, HLA-B, and HLA-DR. HLA matching should be attempted nationwide by adopting different strategies, including typing donors centrally and distributing results to all centers, agreeing on a national point system for allocating organs from deceased donors, and making HLA matching a priority, especially for highly sensitized patients.