Powerful effect of HL-DR matching on survival of cadaveric renal allografts.

Matching for HLA-DR antigens seems to be an effective method of improving the survival rate of cadaveric donor renal allografts; this was shown in the analysis of 190 cadaver transplants in one unit. Patients receiving kidneys well-matched for HLA-DR (no incompatibilities) had a significantly better survival rate (85% at 1 year) than patients with 1 or 2 incompatibilities (64% and 56% respectively, at 1 year). This high survival rate of the DR matched grafts was not due to coincidental better matching of the HLA-A and B antigens. DR matching seems to improve graft survival even in patients who have never been transfused or not. Matching for the limited number of DR antigens mostly with a relatively high antigen frequency should simplify the matching procedure for selection of donor-recipient pairs in cadaveric transplantation.