HLA-DR Matching in Kidney Transplantation: Ethnic Disparities in Clinical Benefit and Policy Implications From a UK Registry Analysis.

ABSTRACT:

Background

The UK Kidney Allocation Scheme (KAS) prioritizes organ allocation based on HLA mismatches, assigning the greatest weight to HLA-DR compatibility. However, the clinical relevance of this approach across different ethnicities in the era of modern immunosuppression remains uncertain.

Methods

We conducted a retrospective cohort study of 25 094 adult deceased donor kidney transplants in the United Kingdom between 2008 and 2020. Using competing risk Cox regression, we evaluated the impact of individual HLA locus mismatches and grouped mismatch levels (as defined by UK-KAS) on graft survival. Subgroup analyses by ethnicity were performed, and the relationship between HLA mismatches and acute rejection was assessed using logistic regression.

Results

A single HLA-D

SUBMITTER: Ali H 

PROVIDER: S-EPMC12771550 | biostudies-literature | 2026 Jan

REPOSITORIES: biostudies-literature