INFLUENCE OF HLA COMPATIBILITY ON KIDNEY- TRANSPLANTATION

The influence of the HLA system on the success rate of kidney transpla ntations was evaluated in a worldwide collaborative study. The results confirm the influence of the HLA chromosome on transplants from relat ed donors. Moreover, a highly significant effect of compatibility for the HLA-A, -B, -DR antigens was observed in cadaver transplants (p < 0 .0001). The great importance of a good quality of tissue typing was em phasized by a) the observation that a significant influence of compati bility for the HLA-A, -B antigens was evident only if donors and recip ients were typed for 'split' specificities and not when they were type d for 'broad' antigens, and b) an improved effect of HLA-DR compatibil ity when serological typing errors were corrected by molecular (DNA) t yping. Computations show that kidney allocation according to the best possible HLA compatibility results in a gain of 800 transplant functio n years per 1,000 transplantations over a 10-year period.