INFLUENCE OF THE RH(D) BLOOD-GROUP SYSTEM ON GRAFT-SURVIVAL IN RENAL-TRANSPLANTATION

Background. The Rh (D) blood group system has not traditionally been c onsidered to be a clinically relevant histocompatibility barrier in tr ansplantation since conflicting results of its clinical importance hav e been reported. Methods. We analyzed 786 consecutive primary cadaveri c renal transplants performed by transplant centers in our Organ Procu rement Organization (OPO) between 1990 and 1997. We also analyzed Unit ed Network for Organ Sharing (UNOS) data on 26,469 kidney transplants done from April 1994 to June 1996. Results. Multivariate analysis reve aled that Rh identity between the recipient and donor was significantl y related to better graft outcome (risk ratio, 0.43; 95% confidence in terval, 0.30 to 0.61; P=0.0001). Multivariate analysis of the UNOS dat a revealed that the Rh-/- group may have a positive influence on graft survival with a risk ratio of 0.43 (P=0.14). Conclusion. Multivariate analysis of primary cadaveric renal allografts performed within the M idwest Organ Bank OPO indicates that Rh (D) is a clinically relevant h istocompatibility barrier that influences 7-year graft survival.