HLA Mismatches and PRA in Kidney Retransplants

1. For kidney transplants, overall graft survival with 1st transplants was better than with multiple transplants. 2. One-year graft survival rates have become similar with 1st and 2nd transplants, but some differences persisted for 5-year survival. 3. HLA mismatches have decreased with both 1st and 2nd DDTs, but with 1st and 2nd LDTs HLA mismatches remained at almost the same level. 4. PRA levels increased with the number of transplants. 5. The percent of 1st transplant patients with 0% PRA has increased year by year. However, with 2nd transplants the percent with higher PRA levels also increased year by year. 6. The trend in number of HLA mismatches was similar with both 1st and 2nd DDTs and LDTs even when higher HLA mismatch levels increased over the years. 7. The graft survival of all PRA levels improved. The differences in 1-year graft survival between each PRA group became smaller, and pretransplant PRA diminished with 1-year graft survival. However, pretransplant PRA still affected 5-year graft survival.