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Nephrology Dialysis Transplantation 2005 20(Supplement 2):ii48-ii53; doi:10.1093/ndt/gfh1082
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Impact of HLA matching on the outcome of simultaneous pancreas–kidney transplantation

Thierry Berney1, Jacques Malaise2, Philippe Morel1, Christian Toso1, Sandrine Demuylder-Mischler1, Pietro Majno1, Léo H. Bühler1, Gilles Mentha1 and the Euro-SPK Study Group

1 Divisions of Visceral and Transplantation Surgery, Geneva University Hospitals, Geneva, Switzerland and 2 Department of Kidney and Pancreas Transplantation and Organ Procurement, Cliniques Universitaires St Luc, Université Catholique de Louvain, Brussels, Belgium

Correspondence and offprint requests to: Dr Jacques Malaise, Department of Kidney and Pancreas Transplantation and Organ Procurement, Cliniques Universitaires St Luc, Université Catholique de Louvain, Avenue Hippocrate, 10/2207, B-1200 Brussels, Belgium. Email: jacques.malaise{at}chir.ucl.ac.be

Background. Simultaneous pancreas–kidney (SPK) transplantation has become the therapy of choice for type 1 diabetic patients with end-stage renal disease. The current analysis examined the impact of human leukocyte antigen (HLA) matching on graft outcome following SPK transplantation. The study population was obtained from patients enrolled in the Euro-SPK 001 study.

Methods. The effect of HLA matching on graft function and survival was assessed in 180 SPK recipients in whom complete donor–recipient HLA data were available. A group of 45 patients with 0–3 HLA mismatches (MM) was compared with a group of 135 patients with 4–6 MM.

Results. There were no differences in 3-year kidney, pancreas or patient survival between the 0–3 and 4–6 MM groups. Biological parameters of kidney and pancreas graft function were similar in both groups. Significantly more patients with 0–3 MM (66%) were rejection-free at 3 years than was the case among those with 4–6 MM (41%; P = 0.003). The relative risk of acute rejection was 2.6 times higher among patients with 4–6 MM than among those with 0–3 MM.

Conclusions. There was no evidence that HLA matching was associated with improved kidney or pancreas survival. However, a higher rate of acute rejection was observed with poor HLA match, which may impact long-term survival.

Keywords: graft survival; HLA matching; kidney–pancreas transplantation; multicentre study; prospective study; rejection


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