HLA-A antigen incompatibility and HLA-B antigen compatibility associated with enhanced kidney allograft survival in blood-transfused patients.

The combined effect on 2-year primary kidney allograft survival of pretransplant blood transfusion, HLA-DR matching, HLA-A matching, HLA-B matching and other factors was analyzed in 116 azathioprine- and prednisolone-treated patients. The results show an hitherto unreported, statistically significant association between incompatibility for HLA-A antigens and enhanced graft survival in transfused recipients of transplants mismatched for HLA-DR (p = 0.005) and for HLA-B (p = 0.008). As expected, compatibility for HLA-B antigens was significantly associated with increased graft survival in transfused recipients of both HLA-DR compatible (p = 0.004) and HLA-DR incompatible (p = 0.01) grafts. If confirmed, the findings foreshadow new aspects of HLA matching in kidney transplantation and might explain the beneficial effect of blood transfusion on renal allograft survival.