Diversity in HLA class I and class II in kidney donors and recipients according to race in KwaZulu-Natal (South Africa) implications for transplantation

Abstract

HLA matching of donors and recipients plays a major role in the success of organ transplantation. Race differences in HLA have been reported elsewhere. Aim: To analyse the diversity of HLA Class I and Class II among kidney donors and recipients according to race. Methods: This is a retrospective study of HLA types of renal patients and kidney donors attending the Renal Unit at Addington and Inkosi Albert Luthuli Central Hospitals from 1985 to 2002. Class I HLA typing was done using serological methods while Class II HLA typing was done using serological or molecular methods at the Tissue Immunology Laboratory, South African National Blood Services, Durban, South Africa. Files for 470 individuals were reviewed. There were 143 Blacks, 169 Indians, 88 Whites and 70 Coloureds. All the files were included and analysed according to race. Results: HLA A locus, 18 distinct antigens were recorded in Black patients. In Indians, 17 antigens were recorded. In Whites, 16 antigens were observed and the most frequent were A2 (29%) and A1 (17%). For the HLA B locus, 29 antigens were recorded in Blacks with the two most frequent being B58 (13%) and B44 (12.5%). In Indians, 28 antigens were recorded. For DR locus 29 distinct antigens were recorded. Conclusion: Race differences in the profile of HLA types are observed. This may render difficult HLA matching between donors and recipients in organ transplantation.