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Long-term graft survival rate of zero-mismatch kidney transplants for HLA-DRB1
Authors:Y. Ichikawa  M. Hashimoto  T. Kinoshita  M. Yamasaki  T. Hanafusa  H. Ihara  M. Sata  H. P. Amemiya  S. Takahara  S. Ohshima
Affiliation:Department of Urology and Kidney Transplant Center, Hyogo Prefectural Nishinomiya Hospital, Rokutaniji-cho 13-9, Nishinomiya, Hyogo 662, Japan;Department of Urology, Hyogo Medical College, Hyogo, Japan;Department of Surgical Research, National Cardiovascular Center Research Institute, Japan;Department of Urology, Osaka University Hospital, Osaka, Japan;Department of Urology, Social Insurance Chukyo Hospital, Japan
Abstract:
Abstract The study of a two-locus association between HLA-B and -DRB1 revealed a significant 43 linkage disequilibrium. Donorrecipient HLA-DRB1 was determined by these 43 linkages. Zeromismatch for HLA-DRB 1 had a significant effect on the graft survival rate in living related and cadaver transplants. The 5-year graft survival rate was 94% in the zero-mismatch group for HLA-DRB 1, 96% for related transplants, 92% for cadaver cases, and 94% in HLA identical siblings. A statistically significant difference was found between the zeromismatch group for HLA-DRB 1 and mismatch groups for HLA-DRB 1 or HLA-DR (P<0.01). The zero-mismatch group for HLADRB 1 had mismatches for HLA-A and/or HLA-B in 46 of 70 cases (66%). No significant differences in the rejection rate was observed between zero-mismatch and mismatch cases for HLA-A and/or -B in the zero-mismatch group for HLA-DRB l. In the second step, genotyping was conducted in 118 cases. The 5-year graft survival rate was 93% in the zero-mismatch group for HLA-DRB 1 and 86% in mismatch group (not a significant difference). We concluded that zero-mismatch transplant for HLA-DRB l had a better long-term graft survival rate regardless of HLA class I.
Keywords:HLA-DRB 1    Kidney transplantation
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