A study of HLA matching in donors and highly sensitized recipients of renal transplantation / 中华泌尿外科杂志

ABSTRACT

Objective To investigate the significance of human leukocyte antigen (HLA) matching in highly sensitized recipients of renal transplantation. Methods 18 highly sensitized recipients preexisting panel reactive antibody IgG (PRA IgG) and their specificities were detected by enzyme linked immunosorbent assay (ELISA) with lambda antigen tray (LAT and LATM). Donors and recipients HLA class I typing was performed using complement dependent cytotoxicity (CDC) test with special monoclonal tray (SMT) and HLA class II gene typing by micro sequence specific primers polymerase chain reaction (Micro PCR SSP). Results PRA IgG positive rate in 18 highly sensitized recipients was between 40%～96% with an average of 56%, patients with 0～1 or 2～3 mismatch (MM) of HLA A,B,DR antigen were 28%(5/18) and 72% (13/18) respectively according to the standard of conventional HLA antigen matching.Whereas cases with 0～1 or 2～3 MM of HLA crossreactive antigen groups (CREGs) were 11 (61%) and 7 (39%) respectively by the rule of CREGs matching and the cases with 0～1 MM increased 33%. Only 4 (22%) cases of posttransplantation developed acute rejection and was reversed by OKT 3 treatment. Conclusions The allocation based on CREGs matching should result in a significantly higher percentage of well matched between donors and recipients. Good HLA matching plays an important role in reducing the incidence of acute rejection and in improving the survival of grafts.