Investigaton of HLA Matching in Sensitized Recipients of Renal Allografts

Objective To investigate the application and significance of human leukocyte antigen (HLA) matching in sensitized recipients of renal allografts.MethodS The donors were selected by HLA CREGs matching for 32 sensitized recipients of renal allografts whose PRA were positive (PRA10%). The post-transplantation outcome was observed. Results The rate of positive PRA in the 32 recipients was from 17% to 89% and averagely 39.84%. Patients with 0,1,2 or 3 MM of HLA CREGs+DR were 8(25%),10(31.25%),12(37.5%)and 2(6.25%) case respectively according to the rule of CRESs matching and no case had 4-6MM in the 32 recipients. However the cases of 0,1,2,3 and 4 MM were 2(6.25%),3(9.38%),10(31.25%),9(28.12%) and 8(25%) respectively and only 5 cases shared 0-1MM when the standard of conventional HLA antigen matching was used.Only 9 patients developed a-cute rejection and were reversed by OKT3 treatment.Renal function returned to normality in all the patients.ConclllSions Using CREGs matching criteria would significantly increase the chance to receive well-matched kidney in recipients and provide more chance for waiting recipients. Good HLA matching plays an important role in reducing the incidence of acute rejection and improving graft survival in the sensitized patients.