USA Pancreas Graft Immunological Loss by Human Leukoyte Antigen (HLA)

For 1-year TS 1999-2003 US DD primary pancreas transplants, HLA matching effect analysis was done for PTA, where the impact has been greatest, as shown in previous annual reports. For the other solitary pancreas transplant category, PAK, it is more difficult to analyze HLA impact because of shared mismatch influences from the kidney donor to which the recipient has already adapted. The 1-year immunological graft loss in PTA cases was not affected by mismatches at the DR locus (Figure 29c) and minimally affected by mismatches at the HLA-A locus (Figure 29a). There was a highly significant effect at the HLA-B locus (Figure 29b). The analysis of the effect of mismatches for Class I antigens (there was no mismatching effect for HLA Class II antigens) was done by combining the HLA-A and HLA-B loci. The immunological graft loss rates by number of Class I antigen mismatches were significant. It was highest with a total antigen mismatch (4AB) and lowest with no mismatches (zero AB) (Figure 29d). With the current immunosuppression regimens used in the PTA group, it is likely prudent to keep the number of HLA Class I mismatches between 0 and 2 for PTA recipients.

Figure 29a

Figure 29b

Figure 29c

Figure 29d

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