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Importance of HLA-DR matching in polytransfused cadaveric kidney transplant recipients. A prospective one-center

Y Vanrenterghem, I Vandeputte, T Lerut

    Transplantation
    |October 1, 1983
    PubMed

    Insights

    Human Leukocyte Antigen (HLA)-DR matching significantly improves kidney transplant survival, even in patients who received multiple blood transfusions. Better HLA-DR matching leads to higher graft survival rates and lower corticosteroid use.

    Area of Science:

    • Immunogenetics
    • Transplantation immunology
    • Nephrology

    Background:

    • Pre-transplant blood transfusions were standard for all recipients.
    • Prospective Human Leukocyte Antigen (HLA)-DR typing was performed for donor-recipient pairs.
    • Kidney allograft survival is influenced by genetic compatibility.

    Purpose of the Study:

    • To evaluate the impact of HLA-DR matching on cadaveric kidney allograft survival.
    • To assess the effect of HLA-DR matching in polytransfused recipients.
    • To determine the influence of HLA-DR matching on corticosteroid dosage.

    Main Methods:

    • Prospective HLA-DR typing in 157 donor-recipient pairs since August 1978.
    • Analysis of graft survival rates based on the number of HLA-DR incompatibilities.
    • Comparison of cumulative corticosteroid doses in the first year post-transplantation.

    Main Results:

    • One-year graft survival was 97% for recipients with no HLA-DR incompatibilities, 86% with one, and 73% with two.
    • HLA-DR matching significantly improved graft survival, irrespective of prior transfusion history.
    • Lower cumulative corticosteroid doses were observed in recipients with no HLA-DR incompatibilities.
    • HLA-A and B matching did not show additional benefits for graft survival.

    Conclusions:

    • HLA-DR matching is a critical factor for successful cadaveric kidney transplantation.
    • Optimizing HLA-DR compatibility can enhance long-term graft survival and reduce immunosuppression requirements.
    • Focusing on HLA-DR matching offers significant clinical benefits in kidney transplantation outcomes.

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