Importance of HLA-DR Matching in Cadaveric Renal Transplantation

To investigate the influence of matching for HLA-DR antigens in renal transplantation, we assessed the outcome of 170 prospectively HLA-typed cadaveric kidney transplantations performed since 1977 in one center. We found a beneficial effect on graft survival of HLA-DR compatibility between donor and recipient (P < 0.05). A possible effect of matching for the HLA-A and B antigens could be seen only in the HLA-DR-mismatched combinations. Pretransplantation blood transfusions were associated with increased graft survival only in patients receiving HLA-DR mismatched transplants (P < 0.02). We conclude that major emphasis should be placed on obtaining HLA-DR compatibility renal transplantation. (N Engl J Med. 1980; 303:850-4).