The Lewis antigen system and its relevance for clinical transplantation

The influence of the Lewis blood group system on transplant survival was studied retrospectively in 161 kidney transplantations. Le (a-b+) recipients had significantly higher graft survival rates than Le (a+b-) or Le (a-b-) recipients. From the known distribution of the Lewis blood groups among the European population, a high percentage of Lewis-compatible transplants would be expected among Le (a-b+) recipients in contrast to the Le (a+b-) and Le (a-b-) recipients. Other factors which are known to influence transplant prognosis such as HLA-match between donor and recipient, ischemic time of the transplants and pretransplant blood transfusions did not differ significantly in any of the three groups studied. Our data again suggest the relevance of the Lewis blood group system for clinical kidney transplantation. The findings should be confirmed by prospective typing of donor and recipient for Lewis antigens.