Abstract
Long lasting debates in the past questioned the relevance of any sort of compatibility in post mortal kidney transplantation. It is for no say that fully compatible transplants have the highest chances for a long patient and graft survival. In the present report the use of HLA-DR as a representative of the Major Histocompatibility Complex class II genes in the allocation of organs is discussed. The major arguments are the easiness to offer to patients a compatible graft in a relatively short waiting time, an increase in graft survival, the less sensitization during the transplantation period, and the lower waiting time for a retransplant. Even if the number of organ donors remains the same a lowering of the mean waiting time is expected because of the longer period of graft survival.
Highlights
The role of HLA compatibility as a parameter for allocation of kidneys from deceased donors to patients on the kidney waiting list remains a matter of debate
It is well accepted that the best possible organ for an end stage renal disease patient is a fully HLA compatible kidney. The arguments of those acting against compatibility do not follow scientific criteria. Both graft and patient survival in post mortal kidney transplantation are significantly better in compatible groups compared to kidneys transplanted with incompatibilities (Doxiadis et al, 2004; Kaneku and Terasaki, 2006; Opelz and Döhler, 2007; Johnson et al, 2010)
Earlier it has been shown that HLA-DR compatibility leads to an increased graft survival for patients receiving a primary graft
Summary
The role of HLA compatibility as a parameter for allocation of kidneys from deceased donors to patients on the kidney waiting list remains a matter of debate. It is for no say that fully compatible transplants have the highest chances for a long patient and graft survival. The major arguments are the easiness to offer to patients a compatible graft in a relatively short waiting time, an increase in graft survival, the less sensitization during the transplantation period, and the lower waiting time for a retransplant.
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