A critical appraisal of HLA matching in today’s renal transplantation

The increased graft survival obtained with poorly matched kidney grafts is for many clinicians a reason to reconsider the value of HLA matching in today’s renal transplantation. Although many other parameters are important, there are still arguments to continue selection of donors on the basis of HL...

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Published in:Transplantation reviews (Philadelphia, Pa.) Pa.), 2004-04, Vol.18 (2), p.96-102
Main Authors: Claas, Frans H.J, Roelen, Dave L, Dankers, Marlies K.A, Persijn, Guido G, Doxiadis, Ilias I.N
Format: Article
Language:English
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Summary:The increased graft survival obtained with poorly matched kidney grafts is for many clinicians a reason to reconsider the value of HLA matching in today’s renal transplantation. Although many other parameters are important, there are still arguments to continue selection of donors on the basis of HLA compatibility with the recipient. Even with the current, very efficient immunosuppression, fully HLA matched combinations have a significantly better graft survival. Furthermore, antibody formation during graft rejection is directly related to the number of mismatched HLA epitopes on the donor organ. HLA matching will prevent that retransplant candidates become highly sensitized, and the incidence of skin cancer after transplantation is significantly lower in HLA matched combinations. Finally, it is to be expected that the threshold to taper or stop the immunosuppression will be lower in HLA matched combinations. As long as the induction of clinical transplantation tolerance is not a routine procedure, a significant proportion of the patients will benefit from a fully HLA matched kidney donor.
ISSN:0955-470X
1557-9816
DOI:10.1016/j.trre.2004.04.007