Association of renal graft survival with matching at the HLA-DR locus.

The influence of HLA-DR antigen matching in 70 cadaver transplants was studied for up to four years. The overall cumulative renal graft survival at one year was 62 percent, and at two and four years it was 60 percent. The one, two, and four year cumulative graft survival for patients receiving one or two HLA-DR antigen matched grafts was 74 percent, 69 percent, and 69 percent, respectively. In contrast, the one, two, and four year cumulative graft survival for patients receiving zero HLA-DR antigen matched grafts was 51 percent, 47 percent, and 47 percent, respectively. The cumulative graft survival for patients receiving one or two HLA-DR antigen matched grafts was significantly different (p less than 0.05) than for patients receiving zero HLA-DR antigen match grafts. No significant difference in the distribution of other prognostic factors were observed between patients receiving one or two HLA-DR antigen match grafts and patients receiving zero HLA-DR antigen matched grafts. The present authors concluded that matching for HLA-DR antigens exerts an independent beneficial effect on renal graft survival in transplant patients, most of whom have been previously transfused.