Opelz G, Wujciak T, Back D, Mytilineos J, Schwarz V, Albrecht G
Institut für Immunologie, Universität Heidelberg.
Infusionsther Transfusionsmed. 1994 Jun;21(3):198-202.
The influence of the HLA system on the success rate of kidney transplantations was evaluated in a worldwide collaborative study. The results confirm the influence of the HLA chromosome on transplants from related donors. Moreover, a highly significant effect of compatibility for the HLA-A, -B, -DR antigens was observed in cadaver transplants (p < 0.0001). The great importance of a good quality of tissue typing was emphasized by a) the observation that a significant influence of compatibility for the HLA-A, -B antigens was evident only if donors and recipients were typed for 'split' specificities and not when they were typed for 'broad' antigens, and b) an improved effect of HLA-DR compatibility when serological typing errors were corrected by molecular (DNA) typing. Computations show that kidney allocation according to the best possible HLA compatibility results in a gain of 800 transplant function years per 1,000 transplantations over a 10-year period.
一项全球合作研究评估了HLA系统对肾移植成功率的影响。结果证实了HLA染色体对亲属供体肾移植的影响。此外，在尸体肾移植中观察到HLA-A、-B、-DR抗原相容性具有高度显著的影响（p<0.0001）。高质量组织配型的重要性体现在以下两点：a）观察发现，只有当供体和受体针对“分裂”特异性进行分型而非针对“宽泛”抗原进行分型时，HLA-A、-B抗原相容性的显著影响才明显；b）当通过分子（DNA）分型纠正血清学分型错误时，HLA-DR相容性的效果得到改善。计算表明，按照最佳HLA相容性进行肾脏分配，在10年期间每1000例移植可增加800个移植功能年。
