Influence of the Lewis blood group system on clinical kidney transplantation.

The different Lewis phenotypes were determined retrospectively in 201 kidney transplant recipients. Transplant survival rates in Lewis compatible recipients were significantly higher (p less than 0.0005) than in Lewis incompatible recipients. The improvement of transplant prognosis by matching for Lewis antigens was confirmed by a prospective study comprising 55 donor/recipient combinations. HLA matching had little benefit on transplant survival whereas survival rates are strikingly increased by Lewis compatibility. In the Lewis compatible but HLA mismatched group, graft survival was definitely higher than in the HLA matched but Lewis mismatched group. Our data indicate that Lewis antigens play an important role in transplant prognosis. Compatibility in the Lewis system should therefore be considered when recipients are selected.