Correlation between relative responses in mixed lymphocyte culture, HLA-D and DR typing, and graft survival in renal transplantation.

Abstract

The impact of renal graft survival of a low relative response (RR) in mixed lymphocyte culture (MLC) and HLA-D/DR compatibility was analyzed. Ninety-five recipients and donors of cadaver kidneys and 58 intrafamilial, HLA-haploidentical, recipient-donor pairs in a Stockholm series constituted the case material. The gene frequencies of and the correlation coefficients between the HLA-D/DR assignments were calculated from an extended material of about 400 individuals, all recipients or donors of renal grafts in Stockholm. Close correlation between the D and DR assignments existed. The combined gene frequencies of the detected D/DR antigens were 0.67 and 0.08. The RR values in the MLC tests were widely scattered, but lower medians were found in the better D/DR-matched groups. The 1-year survival of cadaveric grafts was 69% when the RR values in the MLC between recipient and donor were below 55 and 49% when the RR values were above 55%. The difference was statistically significant (P less than 0.05). Also, significantly higher graft survival rates were obtained in transplants groups where the recipient and donors were well matched for the D and DR antigens. In the transplant groups where no D/DR incompatibility existed, the 1-year graft survival was 93 and 89%, respectively, when the RR values in the MLC tests between recipients and donors were below 55%. We concluded that a close correlation existed between cellular and serological HLA-DS typing. A beneficial effect was noted on graft survival of matching for these antigens.