Speiser D E, Jeannet M, Goumaz C, Tiercy J M
National Reference Laboratory for Histocompatibility, Hôpital Cantonal Universitaire de Genève, Switzerland.
Transpl Immunol. 1994 Dec;2(4):350-2. doi: 10.1016/0966-3274(94)90015-9.
HLA-DR matching was analysed in 111 cadaveric donors and 156 patients who underwent kidney transplantation. We compared the results of conventional DR serology with sequence specific oligonucleotide typing performed on PCR-amplified DRB1 exon 2 DNA. We found discrepancies between serology and DNA typing in 10.1% when the broad antigen specificities DR1-10 were considered. The graft survival probability at 2.5 years between HLA-DR matched versus mismatched transplants was not different (0.87 vs 0.83) when matching was based on serology. However, a significant graft survival difference (0.95 vs 0.82) was found when matching was based on oligotyping for DRB1 (including all subtypes). Furthermore, a better matching for HLA-A and -B was found in the DRB1 matched group. Therefore, precise matching at one particular locus (as shown here for the DRB1 locus) significantly increases the chance to be matched at further MHC loci. The further development of high-resolution typing techniques for most or all HLA-A, -B, -C, -DR, -DQ, -DP antigens may in the future allow more precise definitions of clinically important mismatches helping to develop rational matching strategies.
对111名尸体供者和156名接受肾移植的患者进行了HLA - DR配型分析。我们将传统的DR血清学结果与对PCR扩增的DRB1外显子2 DNA进行的序列特异性寡核苷酸分型结果进行了比较。当考虑DR1 - 10的宽泛抗原特异性时，我们发现血清学和DNA分型之间存在10.1%的差异。当基于血清学进行配型时，HLA - DR配型与不配型移植在2.5年时的移植物存活概率没有差异（0.87对0.83）。然而，当基于DRB1（包括所有亚型）的寡核苷酸分型进行配型时，发现移植物存活存在显著差异（0.95对0.82）。此外，在DRB1配型组中发现HLA - A和 - B的配型更好。因此，在一个特定位点（如此处所示的DRB1位点）进行精确配型显著增加了在其他MHC位点配型的机会。未来，针对大多数或所有HLA - A、 - B、 - C、 - DR、 - DQ、 - DP抗原的高分辨率分型技术的进一步发展可能会使临床上重要的错配得到更精确的定义，有助于制定合理的配型策略。
