THE LEWIS SYSTEM AND KIDNEY TRANSPLANTATION

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Abstract
A significant effect of Lewis antigens on cadaver kidney graft survival was found in 1300 North American transplants. Lewis-negative recipients had a graft survival rate that was 8% lower than that of Lewis-positive recipients (P = 0.05). This effect of Lewis antigens was enhanced in patients at a high failure risk as determined by age, race or transplant center. In patients older than 30 yr the effect of Lewis was 14% (P = 0.07), in non-Caucasians 12% (P = 0.07), in all grafts performed at centers with < 50% overall 1 yr survival graft 12% (P = 0.03), and in non-Caucasians that received transplants in centers with < 50% overall graft survival it was 18% (P = 0.01). These data confirm previous results on the role of Lewis as a histocompatibility system in renal transplantation. The influence of Lewis is larger in patients at high risk.