HLA typing in organ transplant part 14

mhc class 1 & ii

 

It is hoped that these technologies will ultimately lead to the identification of parameters that best correlate with and/or predict transplant outcomes. However, the new techniques have been  associated with decreased specifity, and some  non-HLA antigens with no clinical relevance have been able to give  a positive cross match. These “false-positive” antibody results have a consequence  of decreasing a chance of the patient to receive an organ.

Susal and Opelz done a collaborative transplant study, they summarized that cold ischemia up to 18 hours was found not to be detrimental for graft outcome, and short cold ischemia did not eliminate the effect of HLA matching and HLA-DR mismatches  were a significant risk factor for post transplant non-Hodgin lymphoma and hip fracture.

Meier-Kriesche et al, who examined some 16.000 renal transplant candidates in the USA that were re-listed after loss of a primary kidney transplant, found that with increasing  numbers of HLA mismatches of the first transplant, there was a  significant increase in panel reactive antibody. They also obeserved a pronounced influence  of HLA matching on graft outcome  in patients with pretransplant HLA antibodies or high serum levels of the T cell activation marker sCD30.

 

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