HLA-A, -B, -C, -DR, and -DQ Matching in Pancreas Transplantation: Effect on Graft Rejection and Survival

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
E N RudolphE B Finger

Abstract

To enhance selection of appropriate deceased donors for pancreas transplants, we sought to determine whether HLA matching improved posttransplantation outcomes. In this single-center study of 1219 pancreas transplants, we correlated posttransplantation outcomes with HLA-A, -B, -C, -DR, and -DQ matches and mismatches. Rejection was linearly correlated with the number of mismatches. The individual number of HLA mismatches reached significance at four or more with a 2.3- to 2.9-fold increase in rejection. The effect was most predominant with HLA-B (1.8-fold with one mismatch and 2.0-fold with two mismatches) and -DR (1.9-fold with two mismatches) loci, whereas HLA-A, -C, and -DQ matches or mismatches did not independently predict acute rejection. The affect was strongest in solitary pancreas transplants, with little impact for simultaneous pancreas and kidney (SPK). In contrast, HLA matching did not affect graft or patient survival rates but was associated with a reduced risk of opportunistic infection. Avoidance of acute rejection saved an estimated $32 000 for solitary pancreas recipients and $52 000 for SPK recipients in hospital costs. Our data do not support the use of HLA matching for predicting pancreas graft survival but d...Continue Reading

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Citations

Jul 7, 2020·The Journal of Veterinary Medical Science·Keita SatoTadaaki Moritomo
Jun 22, 2017·Clinical Transplantation·Ehren N RudolphErik B Finger
Dec 23, 2016·Frontiers in Immunology·Andrea A Zachary, Mary S Leffell
Jun 13, 2018·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Pedro Ventura-AguiarMaria José Ricart
May 1, 2021·Journal of Clinical Medicine·Madhivanan Elango, Vassilios Papalois
Jul 11, 2021·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Ugo BoggiThierry Berney
Oct 14, 2021·Transplant International : Official Journal of the European Society for Organ Transplantation·Sandesh ParajuliJon S Odorico

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