Significance of pre-transplant anti-HLA antibodies detected on an ELISA mixed antigen tray platform.

Degree of HLA matching has a highly significant effect on graft survival and this effect has been shown to be potentiated in patients with preformed antibodies.[ 7 8 ] Yet, it has been shown that transplants from living unrelated donors have superior outcomes as compared to similarly matched cadaveric grafts, implying that histoincompatibility is not the only factor.[ 9 ] Another reason postulated for poor outcome in cadaveric transplants is that traumatic brain death is associated with cytokine production, adhesion molecule expression by renal endothelium and renal inflammation, which facilitate rejection.

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