Cadaver renal transplantation and HLA matching in Australia from 1971 to 1980. A report of the Australian and New Zealand Combined Dialysis and Transplant Registry.

The influence of HLA matching on the survival of 2648 cadaver renal grafts carried out in Australian transplant units from January 1971 to October 1980 was analyzed. Survival of grafts well matched for the HLA-A and B antigens was significantly better than that of poorly matched grafts from 1 to 5 years after transplant. The improvement in survival was predominantly attributable to matching for the HLA-B locus antigens, matching for antigens of the HLA-A series contributing only marginally. Although survival of secondary grafts was slightly poorer than that of primary grafts, their survival was improved by HLA matching. No difference in survival on the basis of sex, blood group, or demonstrable presensitization to HLA could be shown, but the influence of HLA matching was greater in males than in females, in group A than group O subjects, and in subjects not sensitized to HLA. In all patient groups, HLA matching based on the number of incompatible antigens carried by the donor had greater prognostic value than matching based on the number of antigens shared by donor and recipient.