HLAmatchmaker: a molecularly based algorithm for histocompatibility determination. III. Effect of matching at the @entity1529 ,B XXXX triplet level on kidney transplant survival.

@entity1 @entity1529 @entity17374 @entity535
BACKGROUND: HLAMatchmaker is a recently developed computer-based algorithm to determine donor-recipient HLA compatibility at the molecular level. Originally designed for highly alloimmunized @entity1 , this algorithm is based on the concept that immunogenic epitopes are represented by @entity535 triplets on exposed parts of protein sequences of @entity17374 chains accessible to alloantibodies. Donor HLA compatibility is determined by intralocus and interlocus comparisons of triplets in polymorphic sequence positions. For most @entity1 , HLAMatchmaker can identify certain mismatched HLA antigens that are zero-triplet mismatches to the @entity1 's HLA phenotype and should, therefore, be considered fully histocompatible. The present study was designed to determine how class I HLA matching at the triplet level affects kidney transplant outcome. METHODS: We analyzed two multicenter databases of zero-HLA-DR-mismatched kidneys transplanted from 1987 to 1999. One database consisted of 31,879 primary allografts registered by U.S. transplant centers in the United Network for Organ Sharing database and the other consisted of 15,872 transplants in the Eurotransplant program. RESULTS: @entity1529 ,B mismatched kidneys that were compatible at the triplet level exhibited almost identical graft survival rates as the zero- @entity1529 ,B antigen mismatches defined by conventional criteria. This beneficial effect of triplet matching was seen for both nonsensitized and sensitized @entity1 and also for white and nonwhite @entity1 . CONCLUSIONS: These findings suggest that the application of HLAMatchmaker will increase the number of successful transplants, at least in the HLA-DR match combinations.
