Prevalence of Human Leukocyte Antigen Incompatibility between Recipients of Live Relative Donor and Deceased Donor in Renal Transplantation in a Tertiary Care Centre in Southern India: A Cross-sectional Study

Introduction: The treatment options available for End-Stage Renal Disease (ESRD) are dialysis or kidney transplantation. Renal transplantation increases the lifespan of the patient and affords a better quality of life when compared to dialysis. The demand for organs is very high compared to the availability of donors. The donors in kidney transplantation can either be a relative (live donor) or a deceased donor. The outcomes of renal transplantation depend on the Human Leukocyte Antigen (HLA) match between the donor and the recipient. Aim: To determine the prevalence of HLA mismatch between recipients of live relative donor kidneys and deceased donor kidneys in renal transplantation. Materials and Methods: The study was a cross-sectional observational study conducted from May 2023 to May 2024 at Government Kilpauk Medical College, Chennai, Tamil Nadu, India after obtaining approval from the Institutional Ethics Committee. Since renal transplantation has been occurring only from May 2023 onwards and the number of samples received for testing was limited, all the samples received for crossmatch testing were included in this study to find the prevalence of HLA incompatibility. HLA crossmatching was performed using the microlymphocytotoxicity test. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 21.0. A Chi-square test was applied to determine the significance of the study results. Results: In this study, 49 live relative donors and 49 recipients were included, along with 12 deceased donors and 42 recipients awaiting renal transplantation. Female donors predominated among live donors, with 34 (69.39%) compared to 15 (30.61%) male donors in the live donor crossmatch. In the deceased donor crossmatch, male donors were predominant, with 7 (58.33%) compared to 5 (41.67%) female donors. The compatibility between live donors and recipients was 48 (97.96%), whereas for deceased donors and recipients it was 35 (83.33%). A comparison of the positive crossmatch between the recipients of live donors and deceased donors showed statistical significance (p-value=0.01438 at 0.05). A Chi-square test was conducted to assess the statistical significance of the Complement Dependent Cytotoxicity (CDC) test crossmatch and Flow Cytometry crossmatch, which was not significant (p-value=0.289013 at 0.05). Conclusion: Live relative donor transplantation has a better match than deceased donor transplantation. The CDC test plays a major role in HLA crossmatching in resource-constrained healthcare facilities.