EVIDENCE THAT MATCHING FOR HLA ANTIGENS SIGNIFICANTLY INCREASES TRANSPLANT SURVIVAL IN 1001 RENAL TRANSPLANTS PERFORMED IN THE NORTHWEST REGION OF ENGLAND
作者:
PHILIP DYER,
ROBERT JOHNSON,
SUSAN MARTIN,
ALI BAKRAN,
RAM GOKAL,
RODNEY HARRIS,
NETAR MALLICK,
JOHN MANOS,
W. Orr,
ROBERT PEARSON,
PATRICK SCOTT,
STEPHEN SHELDON,
COLIN SHORT,
期刊:
Transplantation
(OVID Available online 1989)
卷期:
Volume 48,
issue 1
页码: 131-134
ISSN:0041-1337
年代: 1989
出版商: OVID
数据来源: OVID
摘要:
In the 20-year period from March 1968 to March 1988, 860 patients received 1001 renal transplants in the Northwestern Regional Renal Transplant Unit at Manchester Royal Infirmary. Through a continuing policy of avoiding mismatches for HLA antigens and lymphocytotoxic antibody crossmatching, transplant survival rates were found to correlate with the degree of HLA-A and B antigen mismatching from 1968 to 1978 and with HLA-B and DR antigen mismatching from 1979 to 1988. Mismatching for HLA-B and DR antigens was also found to correlate with transplant survival in highly sensitized patients and in patients transplanted since 1981, the “cyclosporine era.” Recipients who were HLA-DR1 positive were found to have the highest graft survival compared to recipients negative for this antigen. In contrast, HLA-DR3 positive recipients had the poorest outcome. Transplants from HLA-DRw6 positive donors showed higher transplant survival rates than donor kidneys positive for any other HLA-DR antigen. A correlation of transplant survival with HLA-B and DR mismatching was seen whether kidneys were collected within our region or received through the UK Transplant Service.We conclude that avoidance of mismatching for HLA-B and DR antigens confers high transplant survival rates (91.1% at 5 years for 0 HLA-B and DR mismatches), and in order to achieve this rate for most recipients exchange of donor kidneys between transplant centers will be essential.
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