This is the central result of a recent study in the top journal “The Lancet” with more than 500 patients after kidney transplantation, conducted by a global consortium led by Rainer Oberbauer and his colleagues from the Division of Nephrology and Dialysis at the Medical University of Vienna.
It was already clear that the conformance in one area of the major histocompatibility complex on chromosome 6 explains a significant part of transplant survival. However, even if the donor organ and recipient in this region matched perfectly, about 20 percent of the transplants were still lost in the first five years." The team at the Medical University of Vienna has now discovered that this is likely to be caused by a lack of conformance in a large number of other genetic regions. "We were able to confirm this experimentally by the determination of donor-specific antibodies against these non-conforming regions," emphasize the authors of the study. The results suggest that a genome-wide analysis of donor and recipient should be carried out prior to transplantation of living donor kidneys in order to check the tissue match. Moreover, an exchange with other living donor couples might be advantageous if the conditions are not optimal.