Research Article

HLA-DRw6 and renal allograft rejection.

Br Med J (Clin Res Ed) 1983; 286 doi: http://dx.doi.org/10.1136/bmj.286.6359.85 (Published 08 January 1983) Cite this as: Br Med J (Clin Res Ed) 1983;286:85
  1. G F Hendriks,
  2. G M Schreuder,
  3. F H Claas,
  4. J D'Amaro,
  5. G G Persijn,
  6. B Cohen,
  7. J J van Rood

    Abstract

    HLA-DRw6-positive patients are "high responders" to certain renal allograft antigens. A study was therefore conducted of the outcome of 247 first renal allografts in 74 DRw6-positive and 173 DRw6-negative recipients. The effectiveness of matching for HLA-DR determinants in both groups was also analysed. The one-year graft survival in DRw6-positive patients was 59% as compared with 75% in DRw6-negative recipients (p = 0.012). A striking difference between the two groups was that HLA-DR matching significantly improved renal allograft survival only in the DRw6-positive patients. In those patients the one-year survival of HLA-DR-identical grafts was 95% as compared with only 38% for 2-DR mismatched grafts (p = 0.009). In DRw6-negative patients only a slight beneficial effect of HLA-DR matching was observed (83% versus 72% at one year for the 0-DR and 2-DR mismatched grafts, respectively) (p greater than 0.05). These findings are clear evidence that DRw6-positive patients (about a quarter of the patients on the waiting list of Eurotransplant) should be given HLA-DR-identical kidney transplants only.