PMID- 26220289
OWN - NLM
STAT- MEDLINE
DCOM- 20160711
LR  - 20181202
IS  - 1432-1750 (Electronic)
IS  - 0341-2040 (Linking)
VI  - 193
IP  - 5
DP  - 2015 Oct
TI  - Influence of HLA Mismatching on Survival in Lung Transplantation.
PG  - 789-97
LID - 10.1007/s00408-015-9768-9 [doi]
AB  - BACKGROUND: Data on human leukocyte antigen (HLA) mismatching and survival after 
      lung transplantation (LTx) are variable. METHODS: The UNOS database was queried 
      from 1987 to 2013 to examine survival associated with total HLA mismatch >/=3 and 
      mismatches of 2 at A, B, and DR loci. RESULTS: Of 23,528 first-time, adult LTx 
      recipients, 23,384 were included in the univariate Cox analysis, 19,944 in the 
      Kaplan-Meier survival function evaluation, and 16,224 in the multivariate Cox 
      models. Adjusted models found that the total HLA mismatch >/=3 increased the 
      mortality hazard [hazard ratio (HR) 1.214; 95% confidence interval (95% CI) 
      1.073, 1.374; p = 0.002]. Both HLA-A (HR 1.070; 95% CI 1.023, 1.119; p = 0.003) 
      and HLA-DR (HR 1.053; 95% CI 1.007, 1.101; p = 0.024) were associated with 
      increased mortality risk, but HLA-B (HR 1.006; 95% CI 0.958, 1.056; p = 0.805) 
      was not. Older age, higher creatinine, and higher body mass index were associated 
      with increased risk for death. More recent lung transplant and longer ischemic 
      time were associated with reduced mortality risk. Induction with basiliximab at 
      time of transplant was beneficial by significantly decreasing the risk of death 
      (HR 0.846; 95% CI 0.786, 0.909; p < 0.001). CONCLUSIONS: HLA mismatching is 
      associated with increased hazard risk for death after LTx, while induction with 
      basiliximab and other factors related to LTx reduce the risk.
FAU - Hayes, Don Jr
AU  - Hayes D Jr
AD  - Section of Pulmonary Medicine, Department of Pediatrics, Nationwide Children's 
      Hospital, The Ohio State University, 700 Children's Drive, Columbus, OH, 43205, 
      USA. hayes.705@osu.edu.
AD  - Department of Internal Medicine, The Ohio State University, Columbus, OH, USA. 
      hayes.705@osu.edu.
FAU - Whitson, Bryan A
AU  - Whitson BA
AD  - Department of Surgery, The Ohio State University, Columbus, OH, USA.
FAU - Ghadiali, Samir N
AU  - Ghadiali SN
AD  - Department of Internal Medicine, The Ohio State University, Columbus, OH, USA.
AD  - Department of Biomedical Engineering, The Ohio State University, Columbus, OH, 
      USA.
FAU - Tobias, Joseph D
AU  - Tobias JD
AD  - Department of Anesthesiology, The Ohio State University, Columbus, OH, USA.
AD  - Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, 
      Columbus, OH, USA.
FAU - Mansour, Heidi M
AU  - Mansour HM
AD  - Skaggs Pharmaceutical Sciences Center, The University of Arizona College of 
      Pharmacy, Tucson, AZ, USA.
FAU - Black, Sylvester M
AU  - Black SM
AD  - Department of Surgery, The Ohio State University, Columbus, OH, USA.
LA  - eng
PT  - Journal Article
DEP - 20150729
PL  - United States
TA  - Lung
JT  - Lung
JID - 7701875
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (HLA-A Antigens)
RN  - 0 (HLA-B Antigens)
RN  - 0 (HLA-DR Antigens)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Recombinant Fusion Proteins)
RN  - 9927MT646M (Basiliximab)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Antibodies, Monoclonal/therapeutic use
MH  - Basiliximab
MH  - Body Mass Index
MH  - Creatinine/blood
MH  - Graft Rejection/prevention & control
MH  - Graft Survival/*immunology
MH  - HLA-A Antigens/*immunology
MH  - HLA-B Antigens/*immunology
MH  - HLA-DR Antigens/*immunology
MH  - Histocompatibility
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Kaplan-Meier Estimate
MH  - Lung Transplantation/*mortality
MH  - Male
MH  - Middle Aged
MH  - Proportional Hazards Models
MH  - Recombinant Fusion Proteins/therapeutic use
MH  - Registries
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Rate
OTO - NOTNLM
OT  - Hazard risk
OT  - Human leukocyte antigen
OT  - Lung transplantation
OT  - Mismatch
OT  - Mortality
OT  - Survival
EDAT- 2015/07/30 06:00
MHDA- 2016/07/12 06:00
CRDT- 2015/07/30 06:00
PHST- 2015/03/01 00:00 [received]
PHST- 2015/07/19 00:00 [accepted]
PHST- 2015/07/30 06:00 [entrez]
PHST- 2015/07/30 06:00 [pubmed]
PHST- 2016/07/12 06:00 [medline]
AID - 10.1007/s00408-015-9768-9 [pii]
AID - 10.1007/s00408-015-9768-9 [doi]
PST - ppublish
SO  - Lung. 2015 Oct;193(5):789-97. doi: 10.1007/s00408-015-9768-9. Epub 2015 Jul 29.