The Role of Histocompatibilty Antigens in Clinical Transplantation
Controversy surrounding the influence of HLA-A and -B matching in clinical kidney transplantation has not abated since its inception. Clearly, the excellent graft survival of HLA-identical siblings seemed to underline the efficacy of histocompatibility testing. However, HLA-A and -B matching in unrelated donor-recipient pairs, particularly in heterogeneous populations, has not been as successful as anticipated. HLA-D matching, as evidenced by mixed-lymphocyte culture (MLC), has proven to be an excellent indication of graft survival especially in living-related situations. Recent developments, i.e., DRw typing and the beneficial effects of blood transfusions, appear to offer evidence of even better graft survival. In this chapter, we will relate our experience with donor-recipient matching in renal transplants and attempt to place our results in some perspective with evidence from other centers.
KeywordsGraft Survival Histocompatibility Antigen Clinical Transplantation Mixed Lymphocyte Culture Renal Allograft Rejection
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