#5884 HLA COMPATIBILITY DOES NOT INFLUENCE KIDNEY GRAFT SURVIVAL AND DOES NOT IMPACT THE DEVELOPMENT OF POST-TRANSPLANT NEOPLASIA

Abstract Background and Aims HLA compatibility is a key issue in deceased living kidney allocation, although the continuous improvement of immunosuppressive protocols might have reduced its relevance. However, an increased immunosuppression associated with several adverse events, including development post-transplant neoplasia. Indeed, reports demonstrated that drug efficiency corresponded to increase incidence malignancies after transplantation. Thus, aim our study was investigate effect on graft survival Method This observational, retrospective, multicenter center 1506 patients receiving single transplant at Gemelli Policlinico “Consorziale” centers from 1/1/2000 1/2/2022. The primary outcomes were death-censored measured as number mismatches (MM) three main class I (A B) II (DR) loci. To this purpose, both donor recipients genotyped for A, B DR. We included analysis all transplants excluded AB0 incompatible donors pre-transplant specific antibodies. Results Based compatibility, we divided patients’ population groups (0-2 MM, 369 3-4 856 5-6 281 patients). At univariate (Kaplan-Meyer) MM not associate (Logrank p = 0.6) whereas observed significant association neoplasia 0.01). multivariate (Cox model recipient age, induction maintenance therapy) (HR 1.033, 95% CI 0.676-1.580, 0.9) 1.342, 0.853-2.111, 0.2) did any statistically risk develop malignancy. Conclusion In observational retrospective analysis, incompatibility, indicated by DR does predict impact Our observation would suggest missing outcome long-term over-immunosuppression.