Serologically Defined HL-A Antigens and Long-Term Survival of Cadaver Kidney Transplants

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Abstract
A combined study of 918 cadaver renal grafts showed a 70 per cent two-year survival of grafts identical for four HL-A antigens as compared to 34 per cent for those with one or zero identities (p<0.05). Use of the method of calculated incompatibility to avoid potentially incompatible antigens gave a clearer difference between matched and mismatched grafts than when matching was done for detectable incompatibilities alone (at two years, p<0.0001). Antigens of the HL-A first locus were shown to have a relatively weaker but not statistically significant influence on graft survival than those of the second locus. The influence of HL-A antigen matching was greatest in recipients who had a previous failed graft. No influence of recipient lymphocytotoxin status, in terms of graft survival, was demonstrable though preoperative blood transfusion was shown to worsen survival of grafts significantly in the lymphocytotoxin-positive recipients. No effect of increasing transfusion was apparent in the lymphocytotoxin-negative recipients. (N Engl J Med 290:979–984, 1974)