PMID- 24725030
OWN - NLM
STAT- MEDLINE
DCOM- 20150525
LR  - 20181202
IS  - 1432-2277 (Electronic)
IS  - 0934-0874 (Linking)
VI  - 27
IP  - 8
DP  - 2014 Aug
TI  - Human leukocyte antigen matching in heart transplantation: systematic review and 
      meta-analysis.
PG  - 793-804
LID - 10.1111/tri.12335 [doi]
AB  - Allocation of donors with regard to human leukocyte antigen (HLA) is 
      controversial in heart transplantation. This paper is a systematic review and 
      meta-analysis of the available evidence. PubMed, Embase, and the Cochrane Library 
      were searched systematically for studies that addressed the effects of HLA 
      matching on outcome after heart transplantation. Fifty-seven studies met the 
      eligibility criteria. 34 studies had graft rejection as outcome, with 26 of the 
      studies reporting a significant reduction in graft rejection with increasing 
      degree of HLA matching. Thirteen of 18 articles that reported on graft failure 
      found that it decreased significantly with increasing HLA match. Two multicenter 
      studies and nine single-center studies provided sufficient data to provide 
      summary estimates at 12 months. Pooled comparisons showed that graft survival 
      increased with fewer HLA-DR mismatches [0-1 vs. 2 mismatches: risk ratio 
      (RR) = 1.09 (95% confidence interval (CI): 1.01-1.19; P = 0.04)]. Having fewer 
      HLA-DR mismatches (0-1 vs. 2) reduced the incidence of acute rejection 
      [(RR = 0.81 (0.66-0.99; P = 0.04)]. Despite the considerable heterogeneity 
      between studies, the short observation time, and older data, HLA matching 
      improves graft survival in heart transplantation. Prospective HLA-DR matching is 
      clinically feasible and should be considered as a major selection criterion.
CI  - (c) 2014 Steunstichting ESOT.
FAU - Ansari, David
AU  - Ansari D
AD  - Division of Cardiothoracic Surgery, Department of Clinical Sciences Lund, Lund 
      University and Skane University Hospital, Lund, Sweden.
FAU - Bucin, Dragan
AU  - Bucin D
FAU - Nilsson, Johan
AU  - Nilsson J
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20140524
PL  - Switzerland
TA  - Transpl Int
JT  - Transplant international : official journal of the European Society for Organ 
      Transplantation
JID - 8908516
RN  - 0 (HLA-DR Antigens)
SB  - IM
MH  - Graft Survival
MH  - HLA-DR Antigens/genetics/*immunology
MH  - *Heart Transplantation/adverse effects/mortality
MH  - *Histocompatibility Testing
MH  - Humans
MH  - Publication Bias
MH  - Transplantation, Homologous
OTO - NOTNLM
OT  - cardiac allograft vasculopathy
OT  - graft rejection
OT  - graft survival
OT  - heart transplantation
OT  - human leukocyte antigen
OT  - outcome
OT  - patient survival
EDAT- 2014/04/15 06:00
MHDA- 2015/05/26 06:00
CRDT- 2014/04/15 06:00
PHST- 2014/02/12 00:00 [received]
PHST- 2014/03/16 00:00 [revised]
PHST- 2014/04/07 00:00 [accepted]
PHST- 2014/04/15 06:00 [entrez]
PHST- 2014/04/15 06:00 [pubmed]
PHST- 2015/05/26 06:00 [medline]
AID - 10.1111/tri.12335 [doi]
PST - ppublish
SO  - Transpl Int. 2014 Aug;27(8):793-804. doi: 10.1111/tri.12335. Epub 2014 May 24.