Prospective HLA-DR Matching in Cadaveric Renal Transplants: A Single Center Study

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Abstract
Potential cadaveric allograft recipients (77) who had undergone prospective HLA-A and -B locus, and HLA-DR antigen identification were reviewed. Matching was accomplished, giving 1st priority to HLA-DR compatibility and relying on HLA-A and -B antigen matching only in situations of total HLA-DR incompatibility. Complete HLA-DR identification occurred in 56% of all patients. There were 15 patients (19.5%) who received a 2/2 HLA-DR perfect match, with 86.7 .+-. 8.8% 1-yr actuarial graft survival, and 41 (53%) who received a 1/2 HLA-DR match, with 58.2 .+-. 7.8% 1-yr actual allograft survival. Finally, 21 patients (27%) received a 0/2 HLA-DR match, with 64.9 .+-. 10.7% actual survival. These results and their mirrored mismatching results showed statistically significant allograft success in only the HLA-DR 2/2 matches. Matching for HLA 2 DR donors proved a statistically significant success over the other HLA-DR allograft matches and the older controversial matching system based on HLA-A and -B locus antigens. The restricted gene polymorphism of the HLA-DR systems allows for a relatively high percentage of perfect HLA-DR matches.