However, the results of Opelz and Dohler on a large study cohort (135.970 kidneys transplants) clearly showed that the significance of HLA matching on graft survival rate has not lost its importance, and this is obvious when comparing the decades 1985-1994 and 1995-2004. Even when analysing the last five years of the study period separately (2000-2004), a significant correlation of graft survival with HLA matching was disclosed. An analysis of the scientific Registry of transplant recipients database (1988-2007) consisting of > 15.000 re-transplant candidates revealed the negative effect of poor HLA matching on graft survival after the first transplantation and was associated with a significant increase in the development of anti-HLA antibodies measured by panel reactive antibody proportional to increasing HLA mismatches. Only 10% of patients with zero HLA-A and HLA-B mismatches became newly sensitized after graft loss compared to 37% (>30% panel reactive antibody) in transplants with a greater extent of HLA mismatches.
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