[The importance of HLA-matching before kidney transplantation: a recommendation of the Health Council of the Netherlands].

In a recent report, the Health Council of the Netherlands concluded, on the basis of the literature, that HLA-matching is still relevant for graft survival in renal transplant patients. Since the HLA DRantigen system is less heterogeneous than the class I HLA antigen system, it would seem wise to match primarily for these antigens, since this may lead to a reduced exchange of organs between countries and shorten the cold ischaemia period. This may in turn improve the results of transplantation. In the Netherlands, the number of living donor kidney transplants has recently shown a remarkable increase, due partly to the introduction of the paired, living donor, kidney exchange protocol. The introduction of a living donor list exchange programme may further increase this number. Finally, citizens need to be motivated to list themselves as possible organ donors.