Correlation between Magnitude of MLC and Kidney Graft Survival in Intrafamilial Transplantation

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Abstract
The role of HLA-A and -B and HLA-D compatibility was analyzed in 63 recipients of intrafamilial kidney grafts. At 1 yr post-transplantation the survival of grafts from HLA-A and -B compatible donors was 89% and that of grafts from HLA-A and/or -B incompatible donors 77%. Recipients with a Relative Response (RR) in MLC [mixed lymphocyte culture] of < 20% towards their donors, indicating HLA-D compatibility, had a 4 yr graft survival of 100%. After 1 yr the graft survival of this group was statistically different (P < 0.01) from the 63% graft survival of recipients with an RR > 60%. An RR > 60% indicates HLA-D incompatibility between recipient and donor. For patients with RR > 60% the 2 yr graft survival was 46%. This was lower than patients with RR < 20% (P < 0.001) and patients with an RR of 20-60% (P < 0.01). The recipients with an RR of 20-60%, indicating slight HLA-D incompatibility with their donors, had a 2 yr graft survival of 88%. Graft survival was correlated to the magnitude of MLC response between recipients and donors in such a way that a high MLC response indicating HLA-D incompatibility was associated with a high frequency of graft rejection. A low MLC response was associated with graft survival. HLA-D compatibility correlated with an excellent outcome in 5 cases in spite of HLA-A and -B incompatibility.