PMID- 18506564
OWN - NLM
STAT- MEDLINE
DCOM- 20080807
LR  - 20211020
IS  - 1528-1132 (Electronic)
IS  - 0009-921X (Print)
IS  - 0009-921X (Linking)
VI  - 466
IP  - 8
DP  - 2008 Aug
TI  - HLA sensitization and allograft bone graft incorporation.
PG  - 1837-48
LID - 10.1007/s11999-008-0294-4 [doi]
AB  - Achieving union between host bone and massive structural allografts can be 
      difficult. Donor and recipient human leukocyte antigen (HLA) mismatches and 
      recipient antibody response to donor HLA antigens might affect union. In a 
      prospective multiinstitutional study, we enrolled a consecutive series of 
      patients receiving cortex-replacing, massive structural bone allografts to 
      determine the rate of donor-specific HLA antibody sensitization and to 
      investigate the potential effect of such HLA alloantibody sensitization on 
      allograft incorporation. HLA typing of patients and donors was determined by 
      molecular typing methods. Donor-specific HLA sensitization occurred in 57% of the 
      patients but had no demonstrable effect on graft incorporation or union. The type 
      of host-allograft junction did have a major effect on graft incorporation. 
      Cortical-to-cortical allograft-to-host junctions healed more slowly (mean, 542 
      days) than corticocancellous to corticocancellous allograft-to-host junctions 
      (mean, 243 days). Although HLA sensitization does not appear to delay structural 
      allograft bone incorporation, further followup is required to determine if there 
      is an association between HLA sensitization and long-term graft survival. Based 
      on these preliminary data, measures to further minimize or modulate HLA 
      sensitization or response are not indicated at present for the purposes of 
      improving structural bone allograft union. LEVEL OF EVIDENCE: Level II, 
      prognostic study.
FAU - Ward, William G
AU  - Ward WG
AD  - Department of Orthopaedics, Wake Forest University Baptist Medical Center, 
      Medical Center Boulevard, Winston-Salem, NC 27157-1070, USA. wgward@wfubmc.edu
FAU - Gautreaux, Michael D
AU  - Gautreaux MD
FAU - Lippert, Dylan C 2nd
AU  - Lippert DC 2nd
FAU - Boles, Carol
AU  - Boles C
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20080528
PL  - United States
TA  - Clin Orthop Relat Res
JT  - Clinical orthopaedics and related research
JID - 0075674
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Bone Transplantation/*immunology
MH  - Female
MH  - HLA Antigens/*immunology
MH  - Humans
MH  - Immune Tolerance/immunology
MH  - Immunization
MH  - Male
MH  - Orthopedic Procedures
MH  - Prospective Studies
MH  - Transplantation, Homologous
MH  - Wound Healing/immunology
PMC - PMC2584269
EDAT- 2008/05/29 09:00
MHDA- 2008/08/08 09:00
PMCR- 2009/08/01
CRDT- 2008/05/29 09:00
PHST- 2007/11/01 00:00 [received]
PHST- 2008/04/24 00:00 [accepted]
PHST- 2008/05/29 09:00 [pubmed]
PHST- 2008/08/08 09:00 [medline]
PHST- 2008/05/29 09:00 [entrez]
PHST- 2009/08/01 00:00 [pmc-release]
AID - 294 [pii]
AID - 10.1007/s11999-008-0294-4 [doi]
PST - ppublish
SO  - Clin Orthop Relat Res. 2008 Aug;466(8):1837-48. doi: 10.1007/s11999-008-0294-4. 
      Epub 2008 May 28.