Considerably evidence has been obtained that matching for HLA will reduce cellular rejection, thereby promoting survival of kidney and heart transplant recipients. While the HLA system comprises multiple class I and class II genes, most matching strategies consider only three loci: HLA-A, HLA-B and HLA-DR. Although it makes sense to find a perfect match for each transplant recipient, the reality of clinical practice dictates the selection of less-well-matched donors. Current strategies are directed toward identification of donors with permissible or acceptable HLA mismatch.
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