PMID- 26496787
OWN - NLM
STAT- MEDLINE
DCOM- 20161222
LR  - 20181202
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 35
IP  - 2
DP  - 2016 Feb
TI  - Influence of human leukocyte antigen mismatching on bronchiolitis obliterans 
      syndrome in lung transplantation.
PG  - 186-94
LID - S1053-2498(15)01416-3 [pii]
LID - 10.1016/j.healun.2015.08.022 [doi]
AB  - BACKGROUND: Varying results have been reported in the investigation of human 
      leukocyte antigen (HLA) mismatching and bronchiolitis obliterans syndrome (BOS) 
      after lung transplantation (LTx). METHODS: The UNOS database was queried for the 
      period 1997 to 2013 to examine HLA mismatching and its association with BOS in 
      LTx. RESULTS: Of 16,959 first-time adult LTx recipients, 16,854 were included in 
      the univariate Cox analysis and Kaplan-Meier survival function evaluation, and 
      14,578 were included in multivariate Cox models. Multivariate Cox analysis showed 
      that the number of total HLA mismatches was significantly associated with greater 
      hazard of BOS (HR = 1.060; 95% CI 1.013 to 1.108; p = 0.011), as was the presence 
      of 2 HLA-A mismatches, when compared with 0 or 1 mismatch at that locus (HR = 
      1.128; 95% CI 1.026 to 1.240; p = 0.012). These results were confirmed using 
      competing-risks regression models that adjusted for death before BOS diagnosis. 
      Multivariate Cox models identified no significant association with BOS hazard for 
      HLA-B (HR = 1.014; 95% CI 0.914 to 1.126; p = 0.785) or HLA-DR (HR = 1.085; 95% 
      CI 0.987 to 1.193; p = 0.090) mismatches. Higher body mass index was associated 
      with increased risk for BOS, whereas older age was protective against BOS. 
      Induction with alemtuzumab (HR = 0.343; 95% CI 0.252 to 0.467; p < 0.001) or 
      basiliximab (HR = 0.862; 95% CI 0.758 to 0.980; p = 0.023) and longer ischemic 
      time (HR = 0.909; 95% CI 0.877 to 0.942; p < 0.001) were associated with lower 
      hazard of BOS. CONCLUSIONS: Total HLA mismatches are associated with increased 
      risk for BOS, specifically at the A locus. Induction with alemtuzumab or 
      basiliximab reduced the risk, whereas greater ischemic time appears to also be 
      protective.
CI  - Copyright (c) 2016 International Society for Heart and Lung Transplantation. 
      Published by Elsevier Inc. All rights reserved.
FAU - Hayes, Don Jr
AU  - Hayes D Jr
AD  - Departments of (a)Pediatrics; Internal Medicine; Surgery; Section of Pulmonary 
      Medicine. Electronic address: hayes.705@osu.edu.
FAU - Black, Sylvester M
AU  - Black SM
AD  - Surgery.
FAU - Tobias, Joseph D
AU  - Tobias JD
AD  - Anesthesiology, The Ohio State University College of Medicine, Columbus, Ohio; 
      Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, 
      Columbus, Ohio.
FAU - Kopp, Benjamin T
AU  - Kopp BT
AD  - Departments of (a)Pediatrics; Section of Pulmonary Medicine.
FAU - Kirkby, Stephen E
AU  - Kirkby SE
AD  - Departments of (a)Pediatrics; Internal Medicine; Section of Pulmonary Medicine.
FAU - Mansour, Heidi M
AU  - Mansour HM
AD  - Skaggs Pharmaceutical Sciences Center, University of Arizona-Tucson College of 
      Pharmacy, Tucson, Arizona.
FAU - Whitson, Bryan A
AU  - Whitson BA
AD  - Surgery.
LA  - eng
PT  - Journal Article
DEP - 20150925
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 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (HLA Antigens)
RN  - 0 (Recombinant Fusion Proteins)
RN  - 3A189DH42V (Alemtuzumab)
RN  - 9927MT646M (Basiliximab)
SB  - IM
MH  - Age Factors
MH  - Alemtuzumab
MH  - Antibodies, Monoclonal/therapeutic use
MH  - Antibodies, Monoclonal, Humanized/therapeutic use
MH  - Basiliximab
MH  - Bronchiolitis Obliterans/etiology/*immunology
MH  - HLA Antigens/*immunology
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - *Lung Transplantation
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications
MH  - Proportional Hazards Models
MH  - Recombinant Fusion Proteins/therapeutic use
MH  - Syndrome
OTO - NOTNLM
OT  - bronchiolitis obliterans syndrome
OT  - hazard risk
OT  - human leukocyte antigen
OT  - induction therapy
OT  - lung transplantation
OT  - mismatch
OT  - obliterative bronchiolitis
OT  - survival
EDAT- 2015/10/27 06:00
MHDA- 2016/12/23 06:00
CRDT- 2015/10/27 06:00
PHST- 2014/11/20 00:00 [received]
PHST- 2015/08/28 00:00 [revised]
PHST- 2015/08/31 00:00 [accepted]
PHST- 2015/10/27 06:00 [entrez]
PHST- 2015/10/27 06:00 [pubmed]
PHST- 2016/12/23 06:00 [medline]
AID - S1053-2498(15)01416-3 [pii]
AID - 10.1016/j.healun.2015.08.022 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2016 Feb;35(2):186-94. doi: 
      10.1016/j.healun.2015.08.022. Epub 2015 Sep 25.