The effect of HLA matching on patient/graft survival rate of renal transplant recipients positive for PRA

Objective To elucidate the effect of human leukocyte antigen(HLA)cross-reactive groups(CREGs)matching on the patient/graft survival rate of renal transplant recipients positive for penal-reactive antibody(PRA).Methods The PRA level and the HLA antibody specificity of renal transplant candidates were assayed using the LAT1240,LM720R,and SSP2LB kits.The appropriate donors were selected according to the CREGs matching standard.Results 112 recipients included 43 positive cases of HLA classⅠantibody,39 positive cases of HLA classⅡantibody,and 30 positive cases of bothⅠandⅡ.The HLA mismatching cases of 0,1,2,3,4 and 5 allele(s)were 6,39,38, 21,7 and 1,respectively.Hyper-acute rejection(2 cases),acute rejection(18 cases),chronic rejec- tion(5 cases),delayed graft function(4 cases),graft excision(one case)due to rejection and deaths (13 cases,5 with a functioning graft)occurred after transplant.Ninety-nine recipients and 96 grafts survived.The 1-,3-,and 5-year graft survival rate was 91.96%,86.96%,and 86.21%,respec- tively.Conclusion The HLA matching rate of patient/graft was elevated significantly and the effect of high PRA level was decreased according to the principle of CREGs,which increased the patient/graft survival rate remarkably in sensitized recipients.