EFFECT OF HLA-DR3 GENE-EXPRESSION ON CADAVERIC RENAL-ALLOGRAFT SURVIVAL IN BLACKS

The effect of HLA-DR3 gene expression was studied in black cadaveric r enal allograft recipients of organs from the same donor race. From Jan uary 1984 to June 1992, 70 patients received cadaveric renal allograft s at the Medical University of Southern Africa (MEDUNSA). The average age and F:M ratio was 30 years and 1: 1.2 respectively. HLA-A, B and D R matching was zero to one in 80%. Actuarial graft survival at yearly intervals in 22 HLA-DR3 gene expressors was 62, 55, 38, 30 and 24% as compared to 82, 78, 70, 64 and 58% in 48 non-HLA DR3 gene expressors ( Breslow p=0.01 and Mantel-Cox p=0.05). There was no statistical differ ences in creatinine values associated with HLA-DR3 gene expression dur ing the 1st year after transplantation. Renal allografts were lost fro m rejection in 9 out of 16 HLA-DR3 gene expressors as compared to 19 o ut of 29 non-HLA DR3 gene expressors (Fisher's exact test p=0.8). HLA- DR3 gene expression is a risk factor for earlier graft loss in black S outh Africans.