HLA points assigned in cadaveric kidney allocation should be revisited: an analysis of HLA class II molecularly typed patients and donors

Abstract:

The points now assigned for the quality of HLA match have received significant scrutiny to be modified in an effort to help reduce disparity in access to kidneys of minority groups, and since differences in graft survival between groups of patients in each of the HLA matched groups is less now than in the past. We analyzed long‐term (5‐year) graft survival in 746 DR DNA typed recipients of cadaveric kidneys transplanted from 1994–2001 whose donors were also DR DNA typed, with allocation based on those DNA‐based typings. Five‐year graft survival was not significantly different for recipient groups irrespective of if they had zero (84%), one (92%), two (89%), or three to four B, DR mismatches (79%) (log‐rank = 0.15; died with a functioning graft [DWFG] censored). Mismatching of three and four DR and DQ antigens in black but not white patients was associated with significantly worse survival (Relative Risk …

Año de publicación:

2003

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