HLA and Renal Transplantation

Even in the middle to late 1960s, before the HLA-A and -B loci were fully identified, evidence was accumulating that improved graft outcome could be 

Soon after the discovery that HLA matching improves transplant outcome, many centers found that matching for HLA-B antigens is more important than that for HLA-A antigens (D9,02). Some reported no significant effect of matching for HLA-A antigens (e.g., Dl) but the combined experience of most centers indicates 

Five-year graft survival in first cadaveric kidney transplant recipients according to the number of mismatched HLA-A and -B antigens between the donor and the recipient. The number of mismatched antigens (MM) and the number of recipients in each category are shown. Recipients with no mismatched antigens (0 MM) have significantly better outcomes than those with mismatches. All patients included in this analysis were treated with Cyclosporin A. From the Collaborative Transplant Study (G. Opelz, personal communication). 

In the case of living related transplantation, there is little argument that superior results are achieved when sibling donors and recipients share two haplotypes. 

The introduction of the powerful immunosuppressant Cyclosporin A (CyA) in the early 1980s had a revolutionary effect on renal transplantation. 

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