The influence of HLA-DR match on the outcome of cadaver renal transplantation in Stockholm during 1977-1980.

The influence of HLA-DR match grade on graft and on patient survival was analyzed in 124 recipients of cadaver kidneys who were treated in Stockholm between January 1977 and September 1980. The material consisted of 72 males and 52 females, with a mean age of 49 years. There were 34 re-transplantations. Eighteen of the recipients had diabetes. Sera against the HLA-DR antigens 1-4, 7 and DRw8 were available throughout. During recent years, DR5 sera were also used. The case material was analyzed as to the number of DR antigens shared or to the number of DR incompatibilities between the donor and the recipient. A significant improvement in graft survival rate was found for transplants sharing one HLA-DR antigen as compared with those sharing none. As far as incompatibilities are concerned, a significant difference was found between transplants with no incompatibilities and those with two. The HLA-A, B incompatibilities were evenly distributed throughout the various groups and thus should not have introduced a bias in the interpretation of the influence of HLA-DR match. We conclude that HLA-DR matching has a very beneficial effect on the graft survival rate and we shall in future try to obtain the best possible match when selecting recipients for cadaver kidney transplantation.