PMID- 24833649
OWN - NLM
STAT- MEDLINE
DCOM- 20140930
LR  - 20211021
IS  - 1941-3297 (Electronic)
IS  - 1941-3289 (Print)
IS  - 1941-3289 (Linking)
VI  - 7
IP  - 4
DP  - 2014 Jul
TI  - Association of human leukocyte antigen donor-recipient matching and pediatric 
      heart transplant graft survival.
PG  - 605-11
LID - 10.1161/CIRCHEARTFAILURE.113.001008 [doi]
AB  - BACKGROUND: The effect of donor-recipient human leukocyte antigen (HLA) matching 
      on outcomes remains relatively unexplored in pediatric patients. The objective of 
      this study was to investigate the effects of donor-recipient HLA matching on 
      graft survival in pediatric heart transplantation. METHODS AND RESULTS: The UNOS 
      (United Network for Organ Sharing) database was queried for heart transplants 
      occurring between October 31, 1987, and December 31, 2012, in a recipient aged 
      </=17 years with >/=1 postoperative follow-up visit. Retransplants were excluded. 
      Transplants were divided into 3 donor-recipient matching groups: no HLA matches 
      (HLA-no), 1 or 2 HLA matches (HLA-low), and 3 to 6 HLA matches (HLA-high). 
      Primary outcome was graft loss. Four thousand four hundred seventy-one heart 
      transplants met the study inclusion criteria. High degree of donor-recipient HLA 
      matching occurred infrequently: HLA-high (n=269; 6%) versus HLA-low (n=2683; 60%) 
      versus HLA-no (n=1495; 34%). There were no differences between HLA matching 
      groups in the frequency of coronary vasculopathy (P=0.19) or rejection in the 
      first post-transplant year (P=0.76). Improved graft survival was associated with 
      a greater degree of HLA donor-recipient matching: HLA-high median survival, 17.1 
      (95% confidence interval, 14.0-20.2) years; HLA-low median survival, 14.2 
      (13.1-15.4) years; and HLA-no median survival, 12.1 (10.9-13.3 years) years; 
      P<0.01, log-rank test. In Cox-regression analysis, HLA matching was independently 
      associated with decreased graft loss: HLA-low versus HLA-no hazard ratio, 0.86 
      (95% confidence interval, 0.74-0.99), P=0.04; HLA-high versus HLA-no, 0.62 (95% 
      confidence interval, 0.43-0.90), P<0.01. CONCLUSIONS: Decreased graft loss in 
      pediatric heart transplantation was associated with a higher degree of 
      donor-recipient HLA matching, although a difference in the frequency of early 
      rejection or development of coronary artery vasculopathy was not seen.
CI  - (c) 2014 American Heart Association, Inc.
FAU - Butts, Ryan J
AU  - Butts RJ
AD  - From the Department of Pediatrics, Division of Cardiology (R.J.B., M.A.S., 
      A.M.A., A.J.S.), Department of Pathology and Laboratory Medicine, Division of HLA 
      Laboratory (O.M.), Department of Transplant Services, Division of Heart 
      Transplant (A.L.B.), and Department of Pediatrics, Division of Epidemiology 
      (T.C.H.), Medical University of South Carolina, Charleston. butts@musc.edu.
FAU - Scheurer, Mark A
AU  - Scheurer MA
AD  - From the Department of Pediatrics, Division of Cardiology (R.J.B., M.A.S., 
      A.M.A., A.J.S.), Department of Pathology and Laboratory Medicine, Division of HLA 
      Laboratory (O.M.), Department of Transplant Services, Division of Heart 
      Transplant (A.L.B.), and Department of Pediatrics, Division of Epidemiology 
      (T.C.H.), Medical University of South Carolina, Charleston.
FAU - Atz, Andrew M
AU  - Atz AM
AD  - From the Department of Pediatrics, Division of Cardiology (R.J.B., M.A.S., 
      A.M.A., A.J.S.), Department of Pathology and Laboratory Medicine, Division of HLA 
      Laboratory (O.M.), Department of Transplant Services, Division of Heart 
      Transplant (A.L.B.), and Department of Pediatrics, Division of Epidemiology 
      (T.C.H.), Medical University of South Carolina, Charleston.
FAU - Moussa, Omar
AU  - Moussa O
AD  - From the Department of Pediatrics, Division of Cardiology (R.J.B., M.A.S., 
      A.M.A., A.J.S.), Department of Pathology and Laboratory Medicine, Division of HLA 
      Laboratory (O.M.), Department of Transplant Services, Division of Heart 
      Transplant (A.L.B.), and Department of Pediatrics, Division of Epidemiology 
      (T.C.H.), Medical University of South Carolina, Charleston.
FAU - Burnette, Ali L
AU  - Burnette AL
AD  - From the Department of Pediatrics, Division of Cardiology (R.J.B., M.A.S., 
      A.M.A., A.J.S.), Department of Pathology and Laboratory Medicine, Division of HLA 
      Laboratory (O.M.), Department of Transplant Services, Division of Heart 
      Transplant (A.L.B.), and Department of Pediatrics, Division of Epidemiology 
      (T.C.H.), Medical University of South Carolina, Charleston.
FAU - Hulsey, Thomas C
AU  - Hulsey TC
AD  - From the Department of Pediatrics, Division of Cardiology (R.J.B., M.A.S., 
      A.M.A., A.J.S.), Department of Pathology and Laboratory Medicine, Division of HLA 
      Laboratory (O.M.), Department of Transplant Services, Division of Heart 
      Transplant (A.L.B.), and Department of Pediatrics, Division of Epidemiology 
      (T.C.H.), Medical University of South Carolina, Charleston.
FAU - Savage, Andrew J
AU  - Savage AJ
AD  - From the Department of Pediatrics, Division of Cardiology (R.J.B., M.A.S., 
      A.M.A., A.J.S.), Department of Pathology and Laboratory Medicine, Division of HLA 
      Laboratory (O.M.), Department of Transplant Services, Division of Heart 
      Transplant (A.L.B.), and Department of Pediatrics, Division of Epidemiology 
      (T.C.H.), Medical University of South Carolina, Charleston.
LA  - eng
GR  - T32 HL007710/HL/NHLBI NIH HHS/United States
GR  - U54 GM104942/GM/NIGMS NIH HHS/United States
GR  - 5T32-HL07710-17/HL/NHLBI NIH HHS/United States
GR  - 234-2005-370011C/PHS HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20140515
PL  - United States
TA  - Circ Heart Fail
JT  - Circulation. Heart failure
JID - 101479941
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Rejection/epidemiology/*immunology
MH  - Graft Survival/*immunology
MH  - HLA Antigens/*immunology
MH  - *Heart Transplantation
MH  - Humans
MH  - Incidence
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Registries
MH  - Retrospective Studies
MH  - South Carolina/epidemiology
MH  - Survival Rate/trends
MH  - *Tissue Donors
MH  - *Tissue and Organ Procurement
PMC - PMC4102664
MID - NIHMS594190
OTO - NOTNLM
OT  - heart transplantation
OT  - pediatrics
EDAT- 2014/05/17 06:00
MHDA- 2014/10/01 06:00
PMCR- 2015/07/01
CRDT- 2014/05/17 06:00
PHST- 2014/05/17 06:00 [entrez]
PHST- 2014/05/17 06:00 [pubmed]
PHST- 2014/10/01 06:00 [medline]
PHST- 2015/07/01 00:00 [pmc-release]
AID - CIRCHEARTFAILURE.113.001008 [pii]
AID - 10.1161/CIRCHEARTFAILURE.113.001008 [doi]
PST - ppublish
SO  - Circ Heart Fail. 2014 Jul;7(4):605-11. doi: 10.1161/CIRCHEARTFAILURE.113.001008. 
      Epub 2014 May 15.