Potentiating effect of HLA matching and blood transfusion on renal allograft survival

An analysis of HLA (A and B) recipient-donor matching on the outcome of 105 cadaver kidney transplants performed at the Medical College of Virginia transplant center revealed that there is a significant, overall difference (P = 0.03) between recipients receiving kidneys mismatched at two or less HLA loci versus recipients mismatched at three or more loci, the fewer mismatch category showing a better graft survival. The effect of blood transfusion prior to transplantation was studied and found to improve the outlook, especially in the best matched groups. The number of transfusions does show a significant effect (P = 0.04) in the subgroup of patients with two or less mismatches, but for patients with three or more mismatches, the number of transfusions does not seem to matter (P = 0.83). However, in this study even the allografts mismatched at three or more loci had a 1-year graft survival of greater than 65%, indicating that factors other than HLA or blood transfusion play significant roles in the graft outcome. Although the findings are based on a somewhat small number of patients, the statistical significance suggests a potentiating effect of HLA matching and blood transfusion on renal allograft survival.