Gerhard Opelz1, Bernd Döhler. 1. Department of Transplantation Immunology, University of Heidelberg, Heidelberg, Germany. gerhard.opelz@med.uni-heidelberg.de
Abstract
BACKGROUND: Based on an analysis of United Network for Organ Sharing data, it was reported that the influence of human leukocyte antigen (HLA) matching in renal transplantation has diminished in recent years, prompting the suggestion that donor kidney allocation algorithms should be revised. METHODS: We compared the impact of HLA matching on kidney graft survival during the decades 1985-1994 and 1995-2004 using the data of the Collaborative Transplant Study. Results for the last 5 years (2000-2004) were analyzed separately in addition. Multivariate Cox regression analysis was used to account for the influence of confounders. RESULTS: Our results show that, while graft survival rates have improved overall over time, the relative impact of HLA matching on the graft survival rate has remained strong and highly significant. Both the need for posttransplant rejection treatment and the graft survival rates showed statistically highly significant associations with HLA matching regardless of the interval analyzed (P<0.001). CONCLUSIONS: We conclude that HLA mismatches significantly influence the outcome of kidney transplants and that kidney exchange programs for the purpose of achieving better HLA matches continue to be meaningful.
BACKGROUND: Based on an analysis of United Network for Organ Sharing data, it was reported that the influence of human leukocyte antigen (HLA) matching in renal transplantation has diminished in recent years, prompting the suggestion that donorkidney allocation algorithms should be revised. METHODS: We compared the impact of HLA matching on kidney graft survival during the decades 1985-1994 and 1995-2004 using the data of the Collaborative Transplant Study. Results for the last 5 years (2000-2004) were analyzed separately in addition. Multivariate Cox regression analysis was used to account for the influence of confounders. RESULTS: Our results show that, while graft survival rates have improved overall over time, the relative impact of HLA matching on the graft survival rate has remained strong and highly significant. Both the need for posttransplant rejection treatment and the graft survival rates showed statistically highly significant associations with HLA matching regardless of the interval analyzed (P<0.001). CONCLUSIONS: We conclude that HLA mismatches significantly influence the outcome of kidney transplants and that kidney exchange programs for the purpose of achieving better HLA matches continue to be meaningful.
Authors: Robert C Williams; Gerhard Opelz; Chelsea J McGarvey; E Jennifer Weil; Harini A Chakkera Journal: Transplantation Date: 2016-05 Impact factor: 4.939
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Authors: Dulat Bekbolsynov; Beata Mierzejewska; Jadwiga Borucka; Robert S Liwski; Anna L Greenshields; Joshua Breidenbach; Bradley Gehring; Shravan Leonard-Murali; Sadik A Khuder; Michael Rees; Robert C Green; Stanislaw M Stepkowski Journal: Front Immunol Date: 2020-10-29 Impact factor: 7.561