In deceased-donor renal transplantation, mismatch at which HLA locus has the strongest independent association with graft loss and is therefore weighted most heavily in allocation matching?
- A HLA-DR ✓
- B HLA-B
- C HLA-C
- D HLA-A
Correct answer: A. HLA-DR
Explanation
HLA-DR mismatch is the single strongest predictor of graft failure because DR molecules present alloantigen directly to recipient CD4 helper T cells, initiating both cellular and humoral alloimmunity. Class I loci D and B matter but contribute less per mismatch, and HLA-C is not part of routine allocation matching. This is why standard matching schemes report mismatches at D, B and DR loci together.
Reference: Sabiston Textbook of Surgery, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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