From the authors:
Poor results after ABO-incompatible living donor liver transplantation (LDLT) are closely associated with severe hyperacute rejection due to the presence of anti-donor ABO antibodies during the early postoperative period.
Reminder: transplants are not cures. They are, in fact, a treatment for kidney disease. The vast majority of recipients will need multiple transplants to achieve a normal life span.
Recipients must take anti-rejections (aka immunosuppressents) when they have a transplant to keep their body from attacking the transplanted organ. The greater the match between the recipient and the donated organ, the less apt the recipient’s body is to attack, and the longer the graft (transplanted organ) will survive (according to SRTR.org data).
However, advances in anti-rejection medications have resulted in certain transplant surgeons minimizing the importance of HLA matching, and more zero-match transplants are taking now than ever before.
But what happens when a transplant fails, as it usually, eventually does? Recipients are generally then “sensitized”, meaning their body has developed certain antibodies, which makes it that much more difficult to find a second/third/etc. suitable organ.
The authors analyzed the relationship between donor mismatches, and the development of specific HLA antibodies (sensitization). What they found was:
Thus, the risk of allosensitization following failure of a first renal transplant increases incrementally with the number of mismatches at all HLA loci assessed.
Once again, HLA and tissue matching *is* important, not only for graft survival, but for the recipient’s future chance of obtaining additional transplants.