HLA matching: univariate and multivariate analyses of UNOS Registry data. 1991

J Cicciarelli, and Y Cho

1. Black transplant recipients showed little or no matching effect when HLA-A, B, and DR antigens matched. This may have been due in part to differences in serologically defined antigens found in Black populations. 2. There was a statistically significant (p less than 0.001 for best vs worst match) matching effect in White transplant recipients that occurred at 3 months following grafting and continued through 3 years follow-up. These patients had better graft survival for both 5 and 6, compared to 3 and 4, or as compared to 0-, 1-, and 2-match transplants; the corollary groups for mismatched transplants were also significantly different. At 3 years, there was a 20% difference in graft survival from the best- to the worst-matched transplants. Earlier this difference was 7-10% but significantly different. 3. When the HLA Class I parent antigens as defined in the Materials and Methods section were eliminated, there was an increase in graft survival for the best-matched transplants. This was postulated to occur because of better matching obtained by matching the well-defined HLA specificities. 4. With hierarchy matching, possibly there was a stronger effect of matching HLA Class II antigens at 3 months; however, this effect was quickly lost at 1 and 3 years, and data that support early graft survival advantages by matching Class II antigens were inconclusive. Most importantly, there was a threshold matching effect that showed transplant recipients with 4 or more HLA matches or 2 or less mismatches had significantly better short- and long-term outcome than the poorer-matched groups.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007676 Kidney Failure, Chronic The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION. ESRD,End-Stage Renal Disease,Renal Disease, End-Stage,Renal Failure, Chronic,Renal Failure, End-Stage,Chronic Kidney Failure,End-Stage Kidney Disease,Chronic Renal Failure,Disease, End-Stage Kidney,Disease, End-Stage Renal,End Stage Kidney Disease,End Stage Renal Disease,End-Stage Renal Failure,Kidney Disease, End-Stage,Renal Disease, End Stage,Renal Failure, End Stage
D008297 Male Males
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012042 Registries The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers. Parish Registers,Population Register,Parish Register,Population Registers,Register, Parish,Register, Population,Registers, Parish,Registers, Population,Registry
D002140 California State bounded on the east by Nevada and Arizona, on the south by Mexico and the Pacific Ocean on the south and west, and on the north by Oregon.
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup

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