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The clinical investigator

, Volume 70, Issue 9, pp 767–772 | Cite as

Current status of HLA matching in renal transplantation

  • G. Opelz
  • J. Mytilineos
  • T. Wujciak
  • V. Schwarz
  • D. Back for the Collaborative Transplant Study
Guest Lecture, “Gesellscheff fürNephrologie”, 23rd Congress

Summary

The impact of HLA compatibility on the success rate of kidney transplants was studied in over 80,000 recipients of primary transplants. The transplants were done from 1982 to 1991 at over 300 transplant centers in 43 countries. The results show that matching the HLA chromosomes in related donor transplants has a striking influence. It is also important that matching for individual HLA antigens in cadaver transplants provides a highly significant improvement in graft survival (P<0.0001). After 5 years, matched grafts have a survival rate approximately 20% higher than completely mismatched grafts. The matching effect is particularly strong in presensitized and second graft recipients. There is now direct evidence that even if it is necessary to transport well-matched kidneys a long way, they have a significantly higher success rate than locally transplanted poorly matched kidneys. New data based on molecular technology show that the precise identification of HLA-DR antigens by DNA typing further improves the success rate of HLA-matched transplants.

Key words

HLA matching Renal transplantation DNA typing 

Abbreviations

MM

mismatched antigens

RFLP

restriction fragment length polymorphism

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References

  1. 1.
    Matas AJ, Frey DJ, Gillingham KF et al. (1990) The impact of HLA matching on graft survival and on sensitization after a failed transplant — evidence that failure of poorly matched renal transplants does not result in increased sensitization. Transplantation 50:599–607.CrossRefGoogle Scholar
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    Opelz G for the Collaborative Transplant Study (1992) How unusual are the University of Minnesota HLA matching results? Transplantation 53:694–696.CrossRefGoogle Scholar
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    Opelz G, Mytilineos J, Scherer S et al. (1991) Survival of DNA HLA-DR typed and matched cadaver kidney transplants. Lancet 383:461–463.CrossRefGoogle Scholar
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    Mytilineos J, Scherer S, Opelz G (1990) Comparison of RFLP-DRβ and serological HLA-DR typing in 1,500 individuals. Transplantation 50:870–873.CrossRefGoogle Scholar
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    Olerup O, Zetterquist H (to be published) HLA-DRB1 typing by PCR amplification with sequence-specific primers (PCR-SSP): postamplification processing in less than 20 min. In: Tsuji et al. (eds) HLA 1991. Oxford University Press, Oxford.Google Scholar

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • G. Opelz
    • 1
    • 2
  • J. Mytilineos
    • 1
  • T. Wujciak
    • 1
  • V. Schwarz
    • 1
  • D. Back for the Collaborative Transplant Study
  1. 1.Abteilung für Transplantationsimmunologie, Institut für ImmunologieUniversität HeidelbergGermany
  2. 2.Institut für ImmunologieUniversität HeidelbergHeidelbergGermany

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