This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hosenpud, J. D. Articles by Daily, O. P. Search for Related Content PubMed PubMed Citation Articles by Hosenpud, J. D. Articles by Daily, O. P. Pubmed/NCBI databases Medline Plus Health Information Heart Transplantation Lung Transplantation

(Circulation. 1996;94:170-174.)
© 1996 American Heart Association, Inc.

Articles

Influence of HLA Matching on Thoracic Transplant Outcomes

An Analysis From the UNOS/ISHLT* Thoracic Registry

Jeffrey D. Hosenpud, MD; Erick B. Edwards, PhD; Hung-Mo Lin, PhD; O. Patrick Daily, PhD

the Joint Registry of the United Network of Organ Sharing, Richmond, Va, and the International Society for Heart and Lung Transplantation, Dallas, Tex.

Correspondence to Jeffrey D. Hosenpud, MD, Registry Medical Director, Division of Cardiology, Medical College of Wisconsin, 8700 W Wisconsin Ave, Milwaukee, WI 53226.

Background The benefit of matching donor organs and recipients for HLAs has been well established in renal transplantation and has been suggested for thoracic organ transplantation. To determine the effect of HLA matching in cardiac and single-lung transplantation, the following study was performed.

Methods and Results Using the joint Thoracic Transplant Registry of the United Network for Organ Sharing and the International Society for Heart and Lung Transplantation, all adult primary heart and single-lung transplant procedures performed in the United States from October 1987 through December 1993 were analyzed to determine the effects of HLA matching on transplant mortality. Both total HLA matches and matches at individual HLA loci were considered. Including HLA matching, 16 potential risk factors for heart transplant outcome and 16 potential risk factors for lung transplant outcome were subjected to multivariate analysis. A total of 10 752 heart transplants and 1239 lung transplants were included in the independent analyses for each organ. For heart transplantation, there was a progressive reduction in risk for greater matching (1 or 2 matches: risk ratio, 0.83; 3 matches: risk ratio, 0.67; 4 to 6 matches: risk ratio, 0.59; all P.01). The primary benefit of matching appeared to be at the A and DR loci (risk ratios, 0.87 and 0.79, respectively; P<.001). For lung transplantation, any matching had an independent positive effect on outcome; however, the relationship between numbers of HLA matches and relative risk was not present and ranged from risk ratios of 0.71 to 0.87 (P=.01 and P=.47, respectively). In this analysis, only matching at the A locus appeared to statistically influence outcome (risk ratio, 0.76; P=.01).

Conclusions These data demonstrate that HLA matching independently impacts survival in both heart and single-lung transplantation.

Key Words: transplantation • histocompatibility • antigens • survival

This article has been cited by other articles:

				I. George, P. Colley, M. J. Russo, T. P. Martens, E. Burke, M. C. Oz, M. C. Deng, D. M. Mancini, and Y. Naka Association of device surface and biomaterials with immunologic sensitization after mechanical support. J. Thorac. Cardiovasc. Surg., June 1, 2008; 135(6): 1372 - 1379.e1. [Abstract] [Full Text] [PDF]

				D. Schmauss and M. Weis Cardiac Allograft Vasculopathy: Recent Developments Circulation, April 22, 2008; 117(16): 2131 - 2141. [Abstract] [Full Text] [PDF]

				B. P. Griffith, M. Haddad, and R. S. Poston Immunobiology of Heart and Heart-Lung Transplantation Card. Surg. Adult, January 1, 2008; 3(2008): 1513 - 1538. [Full Text]

				A. Y. Sheikh, M. P. Pelletier, and R. C. Robbins Heart-Lung and Lung Transplantation Card. Surg. Adult, January 1, 2008; 3(2008): 1579 - 1608. [Full Text]

				J. P. Jacobs, J. A. Quintessenza, R. J. Boucek, V. O. Morell, L. M. Botero, V. Badhwar, H. M. van Gelder, A. Asante-Korang, J. McCormack, and G. R. Daicoff Pediatric Cardiac Transplantation in Children With High Panel Reactive Antibody Ann. Thorac. Surg., November 1, 2004; 78(5): 1703 - 1709. [Abstract] [Full Text] [PDF]

				R. S. Poston and B. P. Griffith Heart Transplantation J Intensive Care Med, January 1, 2004; 19(1): 3 - 12. [Abstract] [PDF]

				G. Vassalli, A. Gallino, M. Weis, W. von Scheidt, L. Kappenberger, L.K. von Segesser, J.-J. Goy, and on behalf of the Working Group Microcirculation of Alloimmunity and nonimmunologic risk factors in cardiac allograft vasculopathy Eur. Heart J., July 1, 2003; 24(13): 1180 - 1188. [Abstract] [Full Text] [PDF]

				S. Itescu and R. John Interactions between the recipient immune system and the left ventricular assist device surface: immunological and clinical implications Ann. Thorac. Surg., June 1, 2003; 75(90060): S58 - 65. [Abstract] [Full Text] [PDF]

				B. P. Griffith and R. S. Poston Immunobiology of Heart and Heart-Lung Transplantation Card. Surg. Adult, January 1, 2003; 2(2003): 1403 - 1426. [Full Text]

				L. B. Balsam, D. D. Yuh, R. C. Robbins, and B. A. Reitz Heart-Lung and Lung Transplantation Card. Surg. Adult, January 1, 2003; 2(2003): 1461 - 1490. [Full Text]

				R. L. FEATHERSTONE, D. J. CHAMBERS, and F. J. KELLY Comparison of Phosphodiesterase Inhibitors of Differing Isoenzyme Selectivity Added to St. Thomas' Hospital Cardioplegic Solution Used for Hypothermic Preservation of Rat Lungs Am. J. Respir. Crit. Care Med., September 1, 2000; 162(3): 850 - 856. [Abstract] [Full Text]

				C. Y. Wang, I. Aronson, S. Takuma, S. Homma, Y. Naka, T. Alshafie, V. Brovkovych, T. Malinski, M. C. Oz, and D. J. Pinsky cAMP Pulse During Preservation Inhibits the Late Development of Cardiac Isograft and Allograft Vasculopathy Circ. Res., May 12, 2000; 86(9): 982 - 988. [Abstract] [Full Text] [PDF]

				J. F. McCarthy, P. M. McCarthy, M. G. Massad, D. J. Cook, N. G. Smedira, V. Kasirajan, M. Goormastic, K. Hoercher, and J. B. Young Risk Factors for Death After Heart Transplantation: Does a Single-Center Experience Correlate With Multicenter Registries? Ann. Thorac. Surg., June 1, 1998; 65(6): 1574 - 1578. [Abstract] [Full Text] [PDF]

				O. M. Shapira, G. S. Aldea, P. R. Treanor, R. M. Chartrand, K. M. DeAndrade, H. L. Lazar, and R. J. Shemin Reduction of Allogeneic Blood Transfusions After Open Heart Operations by Lowering Cardiopulmonary Bypass Prime Volume Ann. Thorac. Surg., March 1, 1998; 65(3): 724 - 730. [Abstract] [Full Text] [PDF]

				R. E. Helm, T. K. Rosengart, M. Gomez, J. D. Klemperer, W. J. DeBois CPP, F. Velasco, J. P. Gold, N. K. Altorki, S. Lang, S. Thomas, et al. Comprehensive Multimodality Blood Conservation: 100 Consecutive CABG Operations Without Transfusion Ann. Thorac. Surg., January 1, 1998; 65(1): 125 - 136. [Abstract] [Full Text] [PDF]

				L. P. Perrault, P. Menasche, K. V. Ylitalo, and K. J. Peuhkurinen Ischemic Preconditioning Before Normothermic Retrograde Cardioplegia Ann. Thorac. Surg., December 1, 1997; 64(6): 1874 - 1876. [Full Text]