Effect of human leukocyte antigen compatibility on kidney graft survival:: Comparative analysis of two decades

被引:239
作者
Opelz, Gerhard [1 ]
Doehler, Bernd [1 ]
机构
[1] Univ Heidelberg, Inst Immunol, Dept Transplantat Immunol, D-69120 Heidelberg, Germany
关键词
HLA matching; kidney transplant; graft survival; graft rejection;
D O I
10.1097/01.tp.0000269725.74189.b9
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
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.
引用
收藏
页码:137 / 143
页数:7
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