PMID- 18503962
OWN - NLM
STAT- MEDLINE
DCOM- 20080722
LR  - 20080527
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 27
IP  - 6
DP  - 2008 Jun
TI  - Relative impact of human leukocyte antigen mismatching and graft ischemic time 
      after lung transplantation.
PG  - 628-34
LID - 10.1016/j.healun.2008.02.013 [doi]
AB  - BACKGROUND: Recent data strongly suggest that human leukocyte antigen (HLA) 
      mismatching has a negative impact on development of bronchiolitis obliterans 
      syndrome (BOS) and survival after lung transplantation (LTx). Because HLA 
      matching is sometimes achieved by extending ischemic time in other solid-organ 
      transplantation models and ischemic time is a risk factor per se for death after 
      LTx, we sought to compare the theoretical benefit of HLA matching with the 
      negative impact of lengthened ischemic time. METHODS: In this collaborative study 
      we compared the relative impact of HLA mismatching and ischemic time on BOS and 
      survival in 182 LTx recipients. RESULTS: Using multivariate analyses, we observed 
      a lower incidence of BOS (hazard ratio [HR] = 1.70, 95% confidence interval [CI]: 
      1.1 to 2.7, p = 0.03) and enhanced survival (HR = 1.91, 95% CI: 1.24 to 2.92, p = 
      0.01) in patients with zero or one HLA-A mismatch compared with those having two 
      HLA-A mismatches. This beneficial effect on survival was equivalent to a 
      reduction of ischemic time of 168 minutes. CONCLUSIONS: We observed a reduced 
      incidence of BOS and a better survival rate in patients well-matched at the HLA-A 
      locus, associated with an opposite effect of an enhanced ischemic time. This 
      suggests that graft ischemic time should be taken into account in future studies 
      of prospective HLA matching in LTx.
FAU - Brugiere, Olivier
AU  - Brugiere O
AD  - Hopital Bichat, Paris, France. olivier.brugiere@bch.aphp.fr
FAU - Thabut, Gabriel
AU  - Thabut G
FAU - Suberbielle, Caroline
AU  - Suberbielle C
FAU - Reynaud-Gaubert, Martine
AU  - Reynaud-Gaubert M
FAU - Thomas, Pascal
AU  - Thomas P
FAU - Pison, Christophe
AU  - Pison C
FAU - Saint Raymond, Christel
AU  - Saint Raymond C
FAU - Mornex, Jean-Francois
AU  - Mornex JF
FAU - Bertocchi, Michele
AU  - Bertocchi M
FAU - Dromer, Claire
AU  - Dromer C
FAU - Velly, Jean-Francois
AU  - Velly JF
FAU - Stern, Marc
AU  - Stern M
FAU - Philippe, Bruno
AU  - Philippe B
FAU - Dauriat, Gaelle
AU  - Dauriat G
FAU - Biondi, Giuseppina
AU  - Biondi G
FAU - Castier, Yves
AU  - Castier Y
FAU - Fournier, Michel
AU  - Fournier M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adult
MH  - Bronchiolitis Obliterans/*immunology
MH  - Female
MH  - Graft Survival/*immunology
MH  - *HLA Antigens
MH  - Histocompatibility Testing
MH  - Humans
MH  - Ischemia/*complications
MH  - Lung Transplantation/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Time Factors
EDAT- 2008/05/28 09:00
MHDA- 2008/07/23 09:00
CRDT- 2008/05/28 09:00
PHST- 2007/11/16 00:00 [received]
PHST- 2008/02/08 00:00 [revised]
PHST- 2008/02/17 00:00 [accepted]
PHST- 2008/05/28 09:00 [pubmed]
PHST- 2008/07/23 09:00 [medline]
PHST- 2008/05/28 09:00 [entrez]
AID - S1053-2498(08)00182-4 [pii]
AID - 10.1016/j.healun.2008.02.013 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2008 Jun;27(6):628-34. doi: 
      10.1016/j.healun.2008.02.013.