HLA-DRw6 and renal allograft rejection. Issue 6359 (8th January 1983)

• Record Type: Journal Article
• Authors: Hendriks, G F; Schreuder, G M; Claas, F H; D'Amaro, J; Persijn, G G; Cohen, B; van Rood, J J
• Is Part Of: BMJ. Volume 286:Issue 6359(1983)
• Page Start: 85
• Page End: 87
• Publication Date: 1983-01-08
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Periodicals; 610
• DOI: 10.1136/bmj.286.6359.85
• Languages: English
• ISSNs: 0007-1447

Abstract

Abstract : HLA-DRw6-positive patients are "high responders" to certain renal allograft antigens. A study was therefore conducted of the outcome of 247 first renal allografts in 74 DRw6-positive and 173 DRw6-negative recipients. The effectiveness of matching for HLA-DR determinants in both groups was also analysed. The one-year graft survival in DRw6-positive patients was 59% as compared with 75% in DRw6-negative recipients (p = 0.012). A striking difference between the two groups was that HLA-DR matching significantly improved renal allograft survival only in the DRw6-positive patients. In those patients the one-year survival of HLA-DR-identical grafts was 95% as compared with only 38% for 2-DR mismatched grafts (p = 0.009). In DRw6-negative patients only a slight beneficial effect of HLA-DR matching was observed (83% versus 72% at one year for the 0-DR and 2-DR mismatched grafts, respectively) (p greater than 0.05). These findings are clear evidence that DRw6-positive patients (about a quarter of the patients on the waiting list of Eurotransplant) should be given HLA-DR-identical kidney transplants only.