Effect of Human Leukocytic Antigen Matching on Clinical Outcomes after Deceased Donor Renal Allograft Transplant: A Single Centre Experience

M. E. Gramlick¹, M. K. Heer², S. Yausis², P. R. Trevillian²

¹Department of Surgery, John Hunter Hospital, Newcastle, Australia, ²Newcastle Transplant Unit, John Hunter Hospital, Newcastle, Australia

Meeting: 2019 American Transplant Congress

Abstract number: A219

Keywords: HLA matching, Rejection, Renal function, Waiting lists

Session Information

Session Name: Poster Session A: Kidney Deceased Donor Allocation

Session Type: Poster Session

Date: Saturday, June 1, 2019

Session Time: 5:30pm-7:30pm

Presentation Time: 5:30pm-7:30pm

Location: Hall C & D

*Purpose: Human leucocyte antigen (HLA) matching has been the cornerstone of kidney allocation policies. With increasing expertise in assessing and managing immunological risks, the impact of HLA matching is progressively diminishing. We aimed to analyse the outcome of patients who received deceased donor kidneys based on high HLA match compared to poor HLA matched kidneys.

*Methods: Study population included all consecutive adult patients who underwent deceased donor kidney transplant at our centre from 2006 to 2018. Data was extracted from the electronic health records where it is recorded prospectively. Patients were divided in two groups based on HLA matching (group 1 = HLA match >3, group 2 = HLA match ≤3. Data was compared using Mann-Whitney for continuous and Chi square test for categorical variables. A multivariate linear regression model was used to evaluate factors related to graft functions. Other confounders in the model were recipient and donor age and gender, cold ischaemia time and rejection. Data was analysed by Stata 15.1.

*Results: 240 patients were included in the analysis. 147/240(61.2%) recipients were male. Median recipient age was 54 years (IQR 44,63) and donor age was 54 years (IQR 40,65). 104/240(43.33%) patients were in group 1. Demographic profile of both groups was comparable. Group 1 patients had a much shorter time from commencement of dialysis to transplant (34.9 vs 65 months, p=<0.001). 66/240(27.5%) patients experienced at least one episode of rejection. 81/240(33.75%) patients had delayed graft function (DGF). There was no statistically significant difference between the two groups in terms of DGF, episodes of rejection, and glomerular filtration rate (GFR). On linear regression analysis, there was a significant association between donor age and GFR at 1, 3 and 5 years (p=<0.001).

*Conclusions: A significant proportion (43.33%) of recipients received HLA matched kidneys. These recipients enjoyed a much shorter waiting time on dialysis but did not benefit from superior clinical outcomes. Donor age was the only independent variable with a significant relationship to short and mid-term graft function. HLA matching may negatively impact some patients, particularly rare HLA types, as they will wait longer on dialysis.

To cite this abstract in AMA style:

Gramlick ME, Heer MK, Yausis S, Trevillian PR. Effect of Human Leukocytic Antigen Matching on Clinical Outcomes after Deceased Donor Renal Allograft Transplant: A Single Centre Experience [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/effect-of-human-leukocytic-antigen-matching-on-clinical-outcomes-after-deceased-donor-renal-allograft-transplant-a-single-centre-experience/. Accessed November 22, 2024.

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