Strong human leukocyte antigen matching effect in nonsensitized kidney recipients with high pretransplant soluble CD30

The influence of human leukocyte antigen (HILA) matching on graft survival is greater in patients with preformed lymphocytotoxic antibodies than in nonsensitized patients. Pretransplant serum soluble CD30 (sCD30) affects graft outcome independently of presensitization status. The impact of HILA compatibility on kidney transplant survival was analyzed in 3,980 nonsensitized first cadaveric kidney recipients in relation to the pretransplant serum sCD30 content. Although HILA compatibility influenced graft outcome only marginally in nonsensitized recipients with low sCD30 (at 3 years: P=0.0095; at 5 years: P=0.1033), a strong HILA matching effect was observed in nonsensitized recipients with high sCD30 (at 3 years: P < 0.0001; at 5 years: P = 0.0001). Nonsensitized patients with high pretransplant sCD30 benefit from an HLA well-matched kidney. Patients should be tested for sCD30 while on the waiting list for a kidney transplant, and HILA well-matched kidneys should be allocated to patients with high sCD30.