+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Long-term follow-up in London Transplant Group recipients of cadaver renal allografts. The influence of HLA matching on transplant outcome



Long-term follow-up in London Transplant Group recipients of cadaver renal allografts. The influence of HLA matching on transplant outcome



New England Journal of Medicine 314(1): 7-14



The London Transplant Group followed 1341 patients with cadaver renal transplants, none of whom received cyclosporine, for six months to 14 years to determine the effect on graft survival of matching donor and recipient for HLA Class I antigens (HLA-A, -B, and -C) and Class II antigens (HLA-DR, -MT, and -DQ). Long-term graft survival was greatly improved by matching for HLA Class I antigens, especially HLA-B. Transplants that could not be matched for both B-locus antigens but were completely matched for Bw4/Bw6 also did very well. In addition, since 1978, excellent results have been obtained with HLA-DR and -DRw52/53 (HLA-MT) matching, but not with HLA-DQ matching. Multivariate analysis using the Cox regression model confirmed that combination Class I and Class II matching produced significant improvements in graft survival. Thus, transplants matched for HLA-DR plus HLA-B and those matched for HLA-MT plus HLA-B had excellent results--even better than those reported with cyclosporine treatment. Double HLA-MT incompatibilities yielded the poorest results. We conclude that this approach of combining the broad and narrow specificities of Class I and II is extremely practical and that appropriate matching of tissue types is clinically important.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 040597816

Download citation: RISBibTeXText

PMID: 3510010

DOI: 10.1056/nejm198601023140102


Related references

Analysis of long term follow up of london transplant group renal allograft recipients according to hla matching. Transplantation Proceedingspart 1: 50-51, 1985

The long-term fate of cadaver kidney transplants with four defined HL-A antigens (SD1 and SD2 full-house donors): a cumulative case report of 413 consecutive renal allografts from France-Transplant and The London Transplant Group. Transplantation Proceedings 5(3): 1299-1300, 1973

Influence of HLA matching and blood-transfusion on outcome of 502 London Transplant Group renal-graft recipients. Lancet 1(7952): 157-161, 1976

Influence of HL-A matching antigenic strength, and immune responsiveness on outcome of 349 cadaver renal grafts. 3 years' experience of the London transplant group. Lancet 2(7792): 1381-1385, 1972

Pretransplant transfusions antibody status sex and pregnancy in relation to hla a hla b matching in london transplant group recipients of cadaver renal transplants. Transplantation Proceedings 17(6): 2273-2276, 1985

Long term follow up of london england uk transplant group renal transplant patients. Albert, E. P. Baur And W. R. Mayr (ed.). Histocompatability Testing: New York, N.y., Usa; Berlin, West Germany. Illus. 667-668, 1984

Serologically defined HL-A antigens and long-term survival of cadaver kidney transplants. A joint analysis of 918 cases performed by France-Transplant and the London Transplant Group. New England Journal of Medicine 290(18): 979-984, 1974

Influence of original disease on long-term outcome of cadaver kidney transplant. Collaborative Transplant Study. Transplantation Proceedings 28(3): 1148-1149, 1996

Pre-transplant low level HLA antibody shows a composite poor outcome in long-term outcome of renal transplant recipients. Renal Failure 37(2): 198-202, 2015

Long-term follow-up of renal transplant recipients treated with losartan for post-transplant erythrosis. Transplant International 11(4): 312-315, 1998

Is low pre-transplant parathyroid hormone a risk marker for cardiovascular disease in long-term follow-up of renal transplant recipients?. Clinical and Experimental Nephrology 22(5): 1188-1197, 2018

Post-transplant distal limb syndrome: clinical diagnosis and long-term outcome in 37 renal transplant recipients. Transplant International 21(6): 547-553, 2008

Pre-transplant dialysis modality does not influence short- or long-term outcome in kidney transplant recipients: analysis of paired kidneys from the same deceased donor. Clinical Transplantation 30(9): 1097-1107, 2016

The long-term effect of primary disease on cadaver-donor renal transplant recipients. Clinical Transplants 1993: 485-498, 1993

Impact of long term cyclosporine acsa therapy on native kidneys vs renal allografts serial renal function in cardiac and renal transplant recipients. Journal of Urology 141(4 Part 2): 313A, 1989