Impact of HLA-A-B-DR Matching in Kidney Transplantation: Graft and Patient Survival During Five Years

Abstract

Objectives: A successful outcome of renal transplantation depends on various components, with one primary factor being donor and recipient ABO and human leukocyte antigen (HLA) compatibility. The primary aim of our investigation was to determine the impact of HLA-A-B-DR matching on overall and five-year graft and patient survival and to evaluate and improve kidney transplant outcomes. Methods: A total of 70 adult, immunologically low-risk, first-transplant recipients were enrolled in our retrospective study. HLA-A-B-DR typing was performed by the polymerase chain reaction sequence specific primer (PCR-SSP) method. Results: HLA compatibility was carefully matched before transplantation resulting in 81.4% renal transplants with 0-3 HLA mismatches (MM). Overall graft and patient survivals were 52 (74.3%) and 60 (85.7%), respectively, in 70 cases. Five-year graft and patient survivals were 23 (67.6%) and 29 (85.3%), respectively, in 34 cases. A significantly higher rate of graft and patient overall survivals were revealed in the 0-1 MM group compared with those in the 2-3 MM and 4-6 MM groups (p = 0.030 and p = 0.015, respectively). Conclusion: A highly statistically significant correlation of HLA matching enhancing kidney graft and patient survival rates was determined in our analysis. Better HLA matching was associated with better graft and patient survival. Despite the current era of potent immunosuppressive therapy and improved patient management, the data continue support organ sharing based on HLA matching in kidney transplantation.