Kidney transplantation first requires that the blood type between donor and recipient should be in accordance with the principles of blood transfusion: type O accepts type O, type B accepts type B or O, type A accepts type A or O, and type AB can accept type AB or type A or type B or type O. Kidney transplantation requires a negative lymphocytotoxicity test of the recipient’s serum and donor lymphocytes, i.e., the cell killing rate of the lymphocytotoxicity test should be less than 10% as negative, 10%-15% as weakly positive, and greater than 15% as positive. If possible, kidney transplantation requires as many HLA loci as possible to be identical. PRA-positive individuals should be identified with targeted antibodies, and loci with antibodies should be avoided as much as possible when performing HLA matching. Pre-transplantation tissue matching tests: ① ABO blood group matching: strict blood group testing must be performed before kidney transplantation to match the blood group of the donor kidney and the recipient; ②
Lymphotoxicity test (cross fit test): its normal value is less than 10% and more than 15% is positive. This test is the most important reference indicator among the existing tests. Under general conditions, try to choose the recipient with the lowest value to receive a kidney transplant; ③ Human leukocyte antigen (HLA): HLA plays a very important role in allogeneic transplantation. (3) Human leukocyte antigen (HLA): HLA plays a very important role in allogeneic transplantation.
HLA-DR antigens are the most important, HLA-A and HLA-B antigens are the second most important; ④
Population reactive antibodies (PRA): used to determine the immune status and degree of sensitization of the kidney transplant recipient. The degree of sensitization is: no sensitization PRA=0-10%, moderate sensitization PRA=11-50%, and high sensitization PRA>50%, and the survival rate of transplanted kidney decreases sequentially. In particular, if the PRA is >80%, it is generally considered a contraindication to transplantation unless an HLA-matched donor kidney is found.