الفهرس 
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Abstract
The HLA system is the major histocompatibility system in man.
Incompatibility for antigens of the major histocompatibility complex
(MHC)between donor and recipient of an allograft leads to initiation
of an immune response against the graft which ul timately results in
its destruction. The antigens of the major histocompatibili ty complex
are subdivided into class I and class II antigens according to their
distribution and function. Class 1 antigen are expressed on almost
all cells of an organism while class II antigens show restricted
tissue distribution being expressed on B lymphocytes. activated T
lymphocytes, macrophage dendri tic cells and endotheluim.
Incompatibility for either class I or class II antigens can give rise
to an immune response leading to graft rejection, however. it is
possible that class II antigens incompatibility initiate the process of
rejection while class I antigens are the target of cytotoxic T cells
of the recipient.
In our study we correlated HLA-Aand B matehing percentage and
graft survival and we found that with increasing HLA-A.Bmatching percentage
there was an increase in graft survival. decreased number of
rejection episodes. decreased mean serum creatinine and increased
creatinine clearance. So this results must be put in consideration
during selection of the donors.
We have studied the effect of HLA-DRmatching on graft survival
and it was found that there was an increase in graft survival and
a significant decrease in mean number of rejection episodes, but
there was insignificant decrease in mean serum creatinine and creatinine
clearance. These insignificant results may be attributed to shortage
of number of cases included in this comparison.
Also the DRw6 locus was studied and we found that the recipients
with positive DRw6 antigen have poorer first year graft survival,
more number of rejection episodes and dcreased creatinine clearance
than DRw6 negative cases. So, this point must be put in consideration
during selection of the donors as in DRW6 positive recipients,
increase of HLA-DR matching improve graft outcome.
We have studied the effect of immunossupression and HLA% matching
on graft outcome as we compared the graft outcome in each group of
HLA% matching in group traeted with cyclosporin and steriods versus to
azathioprine and steriods. It was found that cyclosporine slightly
improve graft survival and graft function in relation to HLA matching
percentage as compared with azathioprine treated group. So, we advise
to put cases with low HLA percentage matching on cyclosporin to improve
graft survival.
Evaluation of 12 cases of different but matched blood group was
included in this work and we found that these cases are not problems
in living donor kidney transplantation, provided they are accepted to
HLA-ABC and DR matching and they are not presensitized.
Evaluation of 11 cases of unrelated donor kidney transplantation
has lead to the conclusion that unrelated living donors kidney
transplant had a good outcome provided good selection of donors as
regard HLA-A,B and DR matching, negative cross match and puting in
consideration, it is better to be on cyclospor in !’egimen.