For kidney transplants, matching of which three HLA molecules is most important?

In kidney transplant procedures, the most critical aspect of matching involves specific human leukocyte antigen (HLA) molecules to minimize the risk of transplant rejection. The correct answer highlights HLA-A, HLA-B, and HLA-DR as the key components for matching.

These HLA molecules are important because they play a crucial role in the immune response. HLA-A and HLA-B are Class I molecules, primarily involved in presenting endogenous antigens to CD8+ T cells, which are essential for cellular immunity. Matching these molecules helps reduce the potential for cellular rejection, where the recipient's immune system attacks the transplanted kidney.

HLA-DR, on the other hand, is a Class II molecule that presents exogenous antigens to CD4+ T helper cells, which are essential for orchestrating broader immune responses. By matching HLA-DR, clinicians can reduce the risk of antibody-mediated rejection, where the immune system generates antibodies against the foreign antigens of the transplanted kidney.

The focus on these three specific HLA types reflects their significant influence on transplant compatibility. A successful match helps ensure that the recipient's immune system is less likely to recognize the kidney as foreign, thereby promoting transplant acceptance and improving outcomes.

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