engleski

IMPACT OF HLA ANTIGEN DISTRIBUTION AMONG CADAVERIC DONORS ON KIDNEY GRAFT ALLOCATION – A ONE CENTRE EXPERIENCE

In 2007 Croatia became a member of Eurotransplant and since then participates in allocation program in which the kidney recipient's selection list was based on a scoring system which includes a number of HLA-A, - B and -DR mismatches (MM) between patient and cadaveric donor. The aim of this study was to compare HLA-A, -B, -DR antigen distribution among cadaveric donors from Croatia (CRO donors) and donors from other Eurotransplant countries (ET donors) ; to determine the number of MM within patients who received the kidney from the CRO or ET donor and to estimate the benefit of organ exchange for our patients on the kidney waiting list. The study included 861 patients and 707 cadaveric donors (CRO donors N=422, ET donors N=285). Statistically significant differences of specific HLA-A, -B and -DR antigen frequencies between CRO and ET donors were observed. HLA antigens significantly more present among ET donors were HLA-A29 (p=0.0161), B7 (P=0.0048), B8 (P=0.0316), B40 (B60) (P=0.0404) and B44 (P =0.0061) while B35 (P=0.0022), DR11 P=0.0350) and DR16 (P=0.0001) were more frequently present in the CRO donor group. Consequently, patients positive for HLAB7, B8, or B44 antigens statistically significantly more often received a kidney from ET donors (P=0.0016, P=0.0198 and P=0.0312, respectively), while HLA-DR16 positive patients received a kidney more frequently from the CRO donors (P =0.0306). The ABDR MM 000 was more frequently present in the case of transplantation from ET donor (P=0.0005), while MM 222 was significantly more frequent when the donor was from Croatia (P=0.0277). Differences in HLA antigen distribution among populations of Eurotransplant member countries are reflected to kidney allocation and patients from Croatia. Overall MM analysis shows 302 ABSTRACTS that a larger pool of organ donors allows higher probability of HLA highly matched transplantation.

HLA, CADAVERIC DONORS, KIDNEY GRAFT ALLOCATION

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