The clinical outcome of renal transplantation with a poor HLA matched living kidney donors

Sin, Yong Hun; Kim, Hyun Ju; Lee, Hwa Mok; Oh, Joon Seok; Hwang, Hyun Cheol; Im, Dong Han; Kim, Ji Hwan; Park, Chang Soo; Park, Mi Jeong; Oh, Hoe Joo; Park, Yong Ki; Kim, Joong Kyung; Jeon, Gun Ung

Abstract

BACKGROUND: Poor HLA matched donors may become an additional organ source for renal transplantation. This study is conducted to predict the clinical outcomes of renal transplantation in a poor HLA matched group (0 or 1 or 2 HLA matching) by comparing them with those of HLA haploidentical group.
METHODS
This study compared a poor HLA matched group (N=89) with HLA haploidentical group (N=79) to analyze differences between two groups in graft survival, incidence of acute rejection, cause of graft failure, posttransplant serum creatinine at 1, 2, 3, 5 years. Total 168 cases, appeared in the medical records for more than six months in Bong-Saeng Hospital, from December, 1984 to March, 2004 were traced and identified as relevant cases for this study.
RESULTS
Allograft survival rate at 1, 3, 5, 10 years for poor HLA matched group and HLA haploidentical group were 100%, 98.6%, 95.4%, 72.5% and 100%, 100%, 96.1%, 86.2% (p=not significant) respectively. Acute rejection developed in 25.8% of poor HLA matched group versus 18.9% of HLA haploidentical group (p=not significant). The most common causes of graft failure in both groups were chronic rejection.
CONCLUSIONS
It should be actively encouraged to consider renal transplantation in a poor HLA matched group as the results of this study support that the clinical outcomes of renal transplantation in a poor HLA matched group are equivalent to those of HLA haploidentical group.