Figure 819

Classes II and I mismatches in supposed 0 mm shared renal transplantations. The effect on graft survival of shared human leukocyte antigen (HLA) 0mm organs when defined by sero-logic typing and then confirmed by molecular typing. A strong effect of HLA matching is seen at even 1 year on the graft survival. A, Eighty-six first cadaveric kidney transplantations that were reported by serologic typing as HLA-A, -B, -DR "identical-compatible" were tested by molecular methods. Sixty-four transplantations were confirmed to be HLA-DR compatible; however, mismatches were found in the remaining 22 transplantations. Transplantations in which HLA compatibility was confirmed had a functional success rate of 90% at 1 year compared with 68% for transplantations in which the DNA typing revealed HLA-DR mismatches (P < 0.02). B, An analysis of the influence of HLA-class I DNA typing on kidney graft survival is shown. A total of 183 cadaveric transplantations were confirmed to be HLA-A and B compatible after DNA typing, whereas mismatches were found in the remaining 32 cases. Transplantations in which compatibility was confirmed had a functional success rate of 86.9% at 1 year compared with a 71.9% rate for those in which DNA typing revealed HLA-A or -B mismatches (P = 0.033.) (Panel A adapted from Opelz and coworkers [6]; panel B adapted from Mytilineous and coworkers [7]; with permission.)

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