HLA-DRB1 MATCHING AS A RECIPIENT SELECTION CRITERION IN CADAVERIC RENAL-TRANSPLANTATION

We retrospectively examined the effect of HLA-DRB1 matching at the DNA level compared with serological HLA-DR matching on acute rejection an d graft survival in patients who underwent primary cadaveric renal tra nsplantation. For patients with serological HLA-DR zero mismatch, the incidence of acute rejection in patients with zero DRB1 mismatch (3/20 ; 15%) was significantly lower than in those with one or two DRB1 mism atches (10/21; 48%). Five-year graft survival in patients with zero DR B1 mismatch was 100%, whereas that in those with one or two DRB1 misma tches was 76%, although the difference was not statistically significa nt. The fact that HLA-DRB1 matching at the DNA level influenced incide nce of graft rejection after cadaveric renal transplantation is analog ous to results in living-related renal transplantation. It is suggeste d that avoidance of mismatching for DRB1 alleles at the DNA level in r ecipient selection of cadaveric renal transplantation leads to an impr ovement of graft outcome.