DIFFERENTIAL IMPACT OF HLA-A, HLA-B AND HLA-DR COMPATIBILITY ON THE RENAL ALLOGRAFT SURVIVAL

We studied the long-term results of 532 deceased donor kidney transplantations to investigate the impact of HLA match on the survival of renal allograft. All transplants were performed in our center in 1996-2009 and monitored prospectively for 1-14 years. We found, the survival of 58 kidneys grafted with 0-2 mismatch for HLA-ABDR to be significantly better (P-logrank = 0,016) than the survival of the kidneys grafted with 3-6 HLA-ABDR mismatch. The full compatibility for HLA- A (n = 75) did not influence the long-term survival (P-logrank = 0,48). The absence of HLA-DR mismatch had a beneficial effect for survival of 68 kidneys (P-logrank = 0,07). Eighteen cases with the full HLA-B compatibility between graft and recipient demonstrated excellent long-term survival (P-logrank = 0,007). HLA-B compatibility influenced significantly (P = 0,042) the survival of transplanted kidney in the Cox regression model adjusted for donor and recipient age, panel- reactive antibody level, re-transplant, and immunosuppression protocol. The data obtained support the conclusion, that HLA compatibility should be one of the criteria of deceased donor kidney allocation.