Short- and long-term graft survival with 0 antigen-matched first cadaver renal transplants: A single institution study

The importance of HLA matching for cadaver kidney transplantation remains controversial. In some studies, matching has been reported to affect both short- and long-term graft survival. We studied the short- (cyclosporine and prednisone immunosuppression) and long- (azathioprine and prednisone immunosuppression)-term patient and graft survival for recipients of 0 antigen-matched transplants and compared them with survival in those matched for ≥ 1 antigen. All patients were transplanted at the same institution and the HLA typing was done by a single laboratory. For first cadaver kidney recipients (n = 384) there were no significant differences in either short- or long-term patient or graft survival between 0 antigen-matched and ≥ 1 antigen-matched recipients. In fact, 1-year graft survival for the 0 antigen-matched, cyclosporine-immunosuppressed recipient was 87%. Our results compare favorably with all reported data on patient and graft survival where matching is used for kidney allocation. We believe that matching should not be given increased importance in kidney distribution.