HLA match may be key indicator for transplant patient survival

An analysis of registry data from the United Network for Organ Sharing suggests that human leukocyte antigen matching, ¬compared to human leukocyte antigens non-matching results, is a reliable predictor of organ health for patients undergoing kidney transplantation.

Rabi Yacoub, MD, from the division of nephrology at the University of Buffalo, and colleagues from the Icahn School of Medicine at Mount Sinai in New York examined the connection between matching and non-matching human leukocyte antigen (HLA) test results and graft survival among transplant recipients.

“HLA matching and mismatching, while inversely related, are not exact opposites,” Yacoub and colleagues wrote.

Researchers used the United Network for Organ Sharing database from years 1995 to 2012 to examine delayed graft function, acute rejection during the first 12 months post-transplant and death-censored graft survival. Data were then coupled with HLA-matching and mismatching results. A total of 96,236 recipients from the database were examined.

“The results showed that, individually, both HLA matching and mismatching showed significant associations with graft survival,” the authors noted. “Adjusting the model to take into account both matching and mismatching simultaneously, the degree of HLA mismatching lost significance while matching continued to have a significant prediction for delayed graft function, the 1-year acute rejection rate and graft survival,” they wrote. “Thus, analysis of this large cohort demonstrates the apparent greater association of HLA matching over HLA mismatching on both early allograft events, as well as graft survival. Future analyses should preferentially utilize HLA matching as a covariate over mismatching for accurately reflecting impact on graft outcomes.” – by NN&I Staff

Reference:

Yacoub R, et al. Kidney Int. 2017.doi:10.1016/j.kint.2017.07.016.

Disclosures: The authors report no relevant financial disclosures.