THE IMPACT OF HLA-A MATCHING ON LONG-TERM SURVIVAL OF RENAL-ALLOGRAFTS

An important contribution of HLA-A antigen matching in renal transplan tation was reported initially, but later publications showed a minor o r absent role. We analyzed the contribution of HLA-A locus matching to graft survival in 17,672 first renal transplants from unrelated, nonl iving donors. We show that an independent HLA-A matching effect still exists. Due to its relative weakness and late appearance, large number s and longer follow-up periods are required, The HLA-A matching effect is a significant factor in first renal allograft survival up to 6 yea rs after transplantation, with an increasing effect over time. This is in contrast to the strong, short-lived, effects of HLA-DR and -B matc hing, which can only be detected up to 6 months and 2 years after tran splantation, respectively, A clear additive beneficial effect of HLA-A matching is shown in the group without B and DR mismatches, Therefore , prospective matching for the HLA-A antigens remains important for re nal allograft survival.