These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: HLA matching.
    Author: Hata Y, Ozawa M, Takemoto SK, Cecka JM.
    Journal: Clin Transpl; 1996; ():381-96. PubMed ID: 9286584.
    Abstract:
    1. HLA matching exerts a profound influence on graft outcome. The difference in 3-year graft survival rates between best and worst matched cases was 17% for first grafts and 18% for retransplants. This HLA matching effect persists despite recent improvements in graft outcome. The matching effect at 3-years was 12% for transplants since 1991. 2. Surprisingly, HLA matching is especially important for recipients over age 60. The increase in the HLA matching effect to 20% in patients older than 60 can be attributed to the additive effects of HLA matching on both functional and patient survival. Consequently, graft survival for zero-MM recipients is similar for patients older and younger than age 60. 3. The difference in 3-year survival between zero and 0-MM kidneys was 10% for White and 15% for Black recipients. 4. Transplants with zero-broad but split A,B mismatches had graft outcomes similar to one-A,B,DR MM kidneys. Split DR MM did not affect the outcome of zero-MM kidneys. 5. HLA-matched transplants can be classified according to the degree of identity between the donor and recipient: 6-antigen match, phenotypic match, and zero-MM. Outcome for zero-MM was lower in transplants before 1990, but the 3 types have similar outcomes in recent transplants. The change in UNOS matching policy in 1995 to include zero-MM kidneys doubled the number of shared kidneys. 6. HLA typing from over 150 centers resulted in an error rate for shipped kidneys of less than 5%. Donor antigens retyped at the recipient center resulted in identical antigens for 70% of cases, a broad DR MM for 2.2%, and an A,B MM in 2.6% of the retyped cases. 7. Although increasing cold ischemia time (CIT) had a deleterious effect on survival of MM kidneys, no effect was seen for zero-MM kidneys. 8. An effect of a possible sex-linked minor histocompatibility antigen was demonstrated with improved outcome for male to male zero-MM cadaveric and parent-to-child transplants. 9. Zero-MM kidneys from pediatric donors and donors older than 60 years of age had poorer outcome than MM kidneys before 1991, but the recent experience shows a matching effect even with these marginal donors.
    [Abstract] [Full Text] [Related] [New Search]