PMID- 21145259
OWN - NLM
STAT- MEDLINE
DCOM- 20110818
LR  - 20110322
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 30
IP  - 4
DP  - 2011 Apr
TI  - HLA mismatches influence lung transplant recipient survival, bronchiolitis 
      obliterans and rejection: implications for donor lung allocation.
PG  - 426-34
LID - 10.1016/j.healun.2010.10.005 [doi]
AB  - BACKGROUND: Human leukocyte antigen (HLA) histocompatibility is not considered 
      when placing donor allografts for lung transplantation. We previously reported 
      that fewer individual Class I (HLA-A and -B) and Class II (HLA-DR) antigen 
      mismatches (MM) correlated with improved survival in lung transplant recipients. 
      In this study we evaluated whether the effects of total HLA, Class I and Class II 
      MM were more important determinants of: (1) recipient survival; (2) development 
      of bronchiolitis obliterans (BO); and (3) freedom from acute rejection (AR). 
      METHODS: All adult primary cadaveric lung recipients transplanted between April 
      1, 1994, and June 30, 2004 entered in the OPTN database were included (n = 
      9,791). Groups were created based on the total number of HLA, Class I and Class 
      II MM. Recipient survival, freedom from AR and freedom from BO were compared. 
      Univariate data were computed using the Kaplan-Meier method and compared by 
      log-rank test. Multivariate analysis was performed using the Cox proportional 
      hazards method. RESULTS: Univariate analysis identified significantly improved 
      survival in recipients with fewer total HLA (p < 0.001) and Class I MM (p = 
      0.005). The incidence of BO was significantly lower in patients with fewer total 
      Class I MM (p = 0.036). AR was influenced only by Class II MM (p = 0.005). By 
      multivariate analysis, total HLA, Class I and Class II MM impacted recipient 
      survival. Total HLA and Class I MM correlated with development of BO. Class II MM 
      correlated with development of AR. CONCLUSION: HLA MM are important determinants 
      of lung transplant survival, BO and AR. These data suggest that donor-recipient 
      HLA MM may warrant consideration when allocating organs for lung transplantation.
CI  - Copyright (c) 2011 International Society for Heart and Lung Transplantation. 
      Published by Elsevier Inc. All rights reserved.
FAU - Peltz, Matthias
AU  - Peltz M
AD  - Department of Cardiovascular and Thoracic Surgery, University of Texas 
      Southwestern Medical Center at Dallas, TX 75390, USA. 
      matthias.peltz@utsouthwestern.edu
FAU - Edwards, Leah B
AU  - Edwards LB
FAU - Jessen, Michael E
AU  - Jessen ME
FAU - Torres, Fernando
AU  - Torres F
FAU - Meyer, Dan M
AU  - Meyer DM
LA  - eng
PT  - Journal Article
DEP - 20101208
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)
RN  - 0 (HLA-A Antigens)
RN  - 0 (HLA-B Antigens)
RN  - 0 (HLA-DR Antigens)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Bronchiolitis Obliterans/immunology
MH  - Female
MH  - Graft Rejection/immunology
MH  - Graft Survival/immunology
MH  - HLA Antigens/*analysis
MH  - HLA-A Antigens/analysis
MH  - HLA-B Antigens/analysis
MH  - HLA-DR Antigens/analysis
MH  - *Histocompatibility Testing
MH  - Humans
MH  - Lung Transplantation/immunology/*mortality
MH  - Male
MH  - Middle Aged
MH  - Survival Rate
EDAT- 2010/12/15 06:00
MHDA- 2011/08/19 06:00
CRDT- 2010/12/15 06:00
PHST- 2010/02/24 00:00 [received]
PHST- 2010/10/13 00:00 [revised]
PHST- 2010/10/22 00:00 [accepted]
PHST- 2010/12/15 06:00 [entrez]
PHST- 2010/12/15 06:00 [pubmed]
PHST- 2011/08/19 06:00 [medline]
AID - S1053-2498(10)00674-1 [pii]
AID - 10.1016/j.healun.2010.10.005 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2011 Apr;30(4):426-34. doi: 
      10.1016/j.healun.2010.10.005. Epub 2010 Dec 8.