Survival of DNA HLA-DR typed and matched cadaver kidney transplants

• Published in: The Lancet (British edition) 1991-08, Vol.338 (8765), p.461-463
• Main Authors: Opelz, G., Mytilineos, J., Scherer, S., Dunckley, H., Trejaut, J., Chapman, J., Middleton, D., Savage, D., Fischer, G.F., Bignon, J.D., Bensa, J.C., Albert, E., Noreen, H.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Deoxyribonucleic acid; DNA; Kidney transplantation; Kidneys; Medical research; Medical sciences; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Transplants & implants
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/0140-6736(91)90540-6

The clinical value of serological HLA matching for cadaver kidney transplantation remains uncertain because the success rate for HLA-matched cadaver transplants is lower than that of HLA-matched sibling grafts. Up to 25% of serological HLA-DR typings may be incorrect when compared with a more accurate DNA-RFLP method, and we have now examined whether incorrect HLA-DR typings account for the lower than expected success rates of HLA-matched cadaver transplants. 58 transplant centres took part in this study and DNA was extracted from over 4000 samples of frozen tissue at the study centre. 8 laboratories then completed blind RFLP typing for HLA-DR. Serological typing data were reported by individual transplant laboratories. 29 of 107 transplants (27%) that were reported as HLA A, B, DR compatible and 76 of 273 (28%) transplants that were reported as HLA B, DR compatible according to serological typing were found to be HLA-DR mismatched by DNA typing. The one-year transplant success rate for DNA-matched HLA, A, B, DR grafts was 87% compared with 69% for mismatched grafts (p