A study of HLA matching in sensitized recipients of renal transplantation

Objective To investigate the clinical implication of human leukocyte antigen(HLA)matching in sensitized recipients of renal transplantation.Methods Recipient's panel reactive antibody (PRA) was detected by using micro-complement-dependent-lymphocytotoxicity test with Lambda cell tray.Donor and recipient HLA class Ⅰ typing was performed with special monoclonal tray and HLA class Ⅱ gene typing with micro-sequence-specific-primers (Micro-SSP).Results PRA positive rate in 17 recipients was 5.1% to 80% with an average of 37.9%;patients with 0,1 or 2 mismatch (MM) of HLA crossreactive antigen group(CREGs) were 5(29%),8(47%)and 4(24%)cases respectively according to the rule of CREGs matching and no cases had 3-6 MM,however the cases of 0,1 or 2 MM were 1(6%),1(6%)and 8(47%) respectively by the standard of conventional HLA antigen matching and 7(41%)cases had 3-4 MM. Only 3 patients developed acute rejection and were reversed by OKT3 treatment.Renal function retumed normal in all patients.Conclusions The possibility of good matching was greatly enhanced by the CREGs matching.Good HLA matching plays an important role in reducing the incidence of acute rejection and in improving the survival of renal transplants. Key words: Human leukocyte antigen; Panel reactive antibody; Sensitized recipients; Kidney transplantation