HLA-DQ MATCHING IN CADAVERIC RENAL-TRANSPLANTATION

The impact of matching for the human leukocyte antigen (HLA)-DQ phenot ype in cadaveric renal transplantation is unclear. We analyzed the eff ect of matching serologically defined HLA-DQ phenotypes on renal allog raft survival in 12,050 first cadaveric renal transplants (recipients were 63.5% white and 36.5% African-American). Recipients were entered into the South-Eastern Organ Procurement Foundation (SEOPF) database b etween 1 October 1987 and 6 June 1995. A series of life table analyses were done to test the equality of survival curves for HLA-DQ match, b oth alone and accommodating for differences in recipient race and HLA- DR match. Cox regression models were then performed to detect differen ces in allograft survival based upon HLA-DQ match. Initial adjustments were done by recipient race. Subsequent adjustments were done by reci pient and donor race, age and sex, cold ischemia time (CIT), body mass index (BMI), cyclosporine A (CyA) use, peak panel reactive antibody ( PRA) titer, year of transplant, presence of diabetes mellitus (DM), an d degree of HLA-A,B and HLA-DR match as covariates. The effect of vary ing degrees of HLA-DQ match on graft survival were similar between the two races (p=0.87). In all recipients, an 8.3% reduction in graft fai lure was observed for each increase in HLA-DQ match using the Cox regr ession model adjusted only for recipient race (p=0.004). A non-signifi cant 3.0% reduction in graft failure (p=0.38) was observed for each le vel of increasing HLA-DQ match when using the Cox regression model adj usted for recipient and donor race, age and sex, CIT, BMI, CYA use, ye ar of transplant, DM, HLA-A,B and -DR match. In this model, superior H LA-A,B match and HLA-DR match, recipient and donor age, male donor sex , shorter CIT, white race of recipient, lower peak PRA, CyA use, and a bsence of DM significantly improved graft survival (all less than or e qual to 0.004). We conclude that HLA-DQ matching does not significantl y affect cadaveric renal allograft survival once adjusted for other kn own predictors of graft outcome.