EXPERIENCE WITH THE WUJCIAK-OPELZ ALLOCATION SYSTEM IN A SINGLE-CENTER - AN INCREASE IN HLA-DR MISMATCHING AND IN EARLY OCCURRING ACUTE REJECTION EPISODES

The present single-center, retrospective study was undertaken to asses s the impact of the Wujciak-Opelz allocation system (XCOMB), currently used within Eurotransplant for renal allografts, on the incidence of early occurring rejection episodes (RE). Implementation of the system resulted in an increase of HLA-DR mismatches (MM), while the incidence of HLA-A + B + DR MM remained unchanged. During the Ist post-transpla nt month, the total number of RE, expressed per patient-months, increa sed by 64 % (0.326 vs 0.199, P = 0.007); when considering only severe and irreversible RE, the increase was 76 % (0.158 vs 0.090, P = 0.011) . In contrast, from the 2nd to the 12th posttransplant month, the inci dence of RE, regardless of severity, was similar before and after impl ementation of XCOMB. As early occurring RE have detrimental effects on longterm graft: outcome, these observations, if confirmed on a larger scale, would justify changes in the allocation algorithm.