Human Leukocyte Antigen (HLA) Histocompatibility and Kidney Graft Survival

Background: Renal transplantation is the treatment of choice for chronic kidney disease and its survival is known to be related to multiple risk factors. Regarding HLA matching, the number of acute rejection episodes in renal transplantation has been associated with the degree of incompatibility for HLA-DR, as well as a beneficial correlation has been observed between better HLA matching (both HLA-DR and HLA-A and -B) with long-term graft survival. Methods: Descriptive retrospective, 55 post-renal transplant patients were evaluated during January 1, 2018 to December 31, 2019 and followed up for 3 years. Results: Graft survival was evaluated at the first year of follow-up 94% of the grafts had survived out of a total of 55 grafts, at the second year, of the 52 grafts that still had survival 6 (12 of the remaining grafts, and at the third year of follow-up 4 more grafts were lost, the patients who presented HLA-DR compatible had a mean graft survival of 2.85 years. (Figure 1) The survival of the graft was also evaluated in relation to the number of compatibilities that the patients presented, dividing the patients into 4 groups according to the number (0, 1- 2, 3- 4 and 5- 6) in which it was evidenced that the patients who presented 0 compatibilities 100% lost the graft, and those who presented compatibility group 5-6, had 100% survival (CI: 95%) at 3 years of follow-up of patients, among patients who were among the groups 1-2 and 3-4, had a graft survival at the end of the study in 78.2% and 80.1% respectively, and very similar data. (Figure 2) Conclusion: HLA matching was significant for graft survival, mainly HLA-DR. It is important to continue investigating in our population with longer follow-ups as well as the follow-up approach to patients who do not share HLA