ABSTRACT
Objective To investigate the influence of HLA immunogenic mismatching (IM) on acute rejection of renal transplants.Methods The function recovery time of renal allograft and the rate of acute rejection of 196 cases after cadaveric renal transplantation wereanalyzed. Results IM of HLA locus did not influence the function recovery time of the renal allograft. The IM of HLA-A locus did not increase the rate of allograft acute rejection whereas the HLA-B locus did and the HLA-DR increased the acute rejection rate significantly. Conclusion IM should not be ignored in HLA typing. HLA-B locus is related to the allograft acute rejection, while the IM of DR locus increasesthe allograft acute rejection rate significantly.
ABSTRACT
BACKGROUND: Patients with platelet refractoriness as a result of human leukocyte antigen (HLA) alloimmunization can be effectively managed by transfusion of HLA-matched platelets. In this study, we have retrospectively evaluated the effect of HLA-matched platelet transfusion using a hospital based donor pool of 450 HLA typed donors. METHODS: For 17 patients showing platelet refractoriness to random donor platelets [1 hr corrected count increment (CCI) or =7, 500/microliter/m2) was obtained. HLA crossmatch (NIH method) negative patients showed a significantly higher platelet increment compared with crossmatch positive patients (23, 877 vs 10, 823; P=0.000). Although better transfusion effect was obtained in higher grade HLA match of A-B2U by selection of HLA compatible donors according to patients' HLA antibody specificities, an effective platelet increment was obtained in lower grade matches as well. Platelets transfused 24 hours (20, 325 vs 11, 417; P=0.029). CONCLUSIONS: Although many low grade matched donors were selected due to a relatively small size of HLA typed donor pool, effective platelet increments were obtained by selecting platelet donors on the basis of HLA antibody specificity.
Subject(s)
Humans , Antibody Specificity , Blood Component Removal , Blood Platelets , Leukocytes , Platelet Transfusion , Retrospective Studies , Tissue DonorsABSTRACT
There still is debates on the effect and the value of HLA matching on graft survival in clinical renal transplantation. A few reports were presented in Korea about the effect, where over 95% of kidneys have been taken from living donor, and the results are inconclusive. So, we analysed 329 cyclosporine treated first living donor renal transplantation performed in Keimyung University Dongsan medical center, from Nov. 1982 to Feb. 1996 to determine the effect of HLA matching on graft outcome. Significant survival benefits were observed at 5 years between HLA-B 0 mismatch(MM) and more than 0 MM (89.73% vs 64.68, 60.26%, p<0.05), A+B 0 MM and more than 0 MM(94.28% vs 63.94, 63.43, 56.25%, p<0.05), B+DR 0 MM and 2, 3 MM(89.59% vs 61.82, 64.98%, p<0.05), and A+B+DR 0 MM and 3, 4 MM(92.57% vs 56.82, 63.19%, p<0.05). But HLA-A or DR mismatch alone seemed to have no effect on graft survival. Our results showed some beneficial effect of HLA match on renal graft survival but yet inconclusive due to small size of the number.