Six-antigen-matched transplants. Causes of failure

Transplantation
S TakemotoP I Terasaki

Abstract

The causes of failure were studied for 1386 cadaver kidney transplants shared through the UNOS 6-antigen match program from November 1987 to February 1992. The one-year graft survival for 1004 HLA-matched first cadaver transplants was 88% compared with 90% for parent donor and 78% for 22,188 HLA-mismatched first cadaveric donors reported to the UNOS Scientific Renal Transplant Registry. The cause of graft loss was immunological in 55% of HLA-mismatched cadaver kidney failures, whereas only 39% of the HLA-matched graft failures were immunological. The fraction of immunological failures in HLA-matched first transplant recipients younger than age 17 was 57% and decreased with increasing age to 14% for recipients older than age 60. Death with a functioning graft accounted for 50% of failures in the older age group. Sensitization was associated with an increased incidence of immunological failures in matched first graft recipients from 36% in nonsensitized to 53% in broadly sensitized patients, and 55% of failures were immunological in second graft recipients compared with 39% in first transplants. Some immunological failures may have been due to tissue typing, since only 18% of failures in kidneys with well-defined HLA antigens wer...Continue Reading

Citations

Jan 29, 2000·Journal of Immunological Methods·D R JohnsonB Mook-Kanamori
Dec 20, 2000·Transplantation Proceedings·M HirataM Makuuchi
Nov 20, 1997·Transplantation Proceedings·H U KlehrD Heimbach
Aug 1, 1997·Human Immunology·J M Cecka
Jun 21, 2007·Transplantation Proceedings·J TanX Tang
Oct 8, 2008·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·H A GritschJ M Cecka
Apr 9, 1998·The Surgical Clinics of North America·M Suthanthiran, T B Strom
Nov 26, 2004·Journal of the American Society of Nephrology : JASN·Harini A ChakkeraGlenn M Chertow

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