Degree of human leukocyte antigen mismatch and its effect on live donor kidney transplant recipients

Abstract

Background: There is a strong evidence of importance of HLA matching in kidney
transplantation and associations between HLA-DR mismatches and rejection, transplant
glomerulopathy, graft failure, and death with functioning graft following kidney
transplantation.
Objective: to evaluate the effect of degree of HLA mismatch on live donor kidney transplant
recepients.
Patients and Method: The current study is a retrospective cohort study which was
performed in Urology and Nephrology Center, Mansoura University, Egypt. The study
included 2200 kidney transplant recipients who underwent renal transplantation between
March 1976 and August 2019. The patients were divided into 3 main groups according to the
degree of HLA mismatch: Group I: 0, 1, 2 HLA mismatch (568 patients). Group II: 3 , 4
HLA mismatch (1462 patients). Group III: 5 HLA mismatch (170 patients)
Results: Demographic and medical characteristics were comparable among the 3 groups.
Transplantation from unrelated donors was more frequent among group III (p value: 0.001).
Ischemia time was comparable and over 90% of the patients had immediate diuresis.
Incidence of post-transplant Hypertension and Diabetes mellitus was higher in group III (p
value: 0.004, 0.016 respectively).
Conclusions: Higher HLA mismatch was associated with higher incidence of diabetes and
hypertension and has no effect on other medical and surgical complications.