PMID- 32441827
OWN - NLM
STAT- MEDLINE
DCOM- 20210624
LR  - 20210624
IS  - 1432-2277 (Electronic)
IS  - 0934-0874 (Print)
IS  - 0934-0874 (Linking)
VI  - 33
IP  - 9
DP  - 2020 Sep
TI  - Molecular-level HLA mismatch is associated with rejection and worsened graft 
      survival in heart transplant recipients - a retrospective study.
PG  - 1078-1088
LID - 10.1111/tri.13657 [doi]
AB  - The aim was to evaluate the association of molecular-level human leukocyte 
      antigen (HLA) mismatching with post-transplant graft survival, rejection, and 
      cardiac allograft vasculopathy (CAV). We retrospectively analyzed all primary 
      cardiac transplant recipients between 01/1984-06/2016. 1167 patients fulfilled 
      inclusion criteria and had HLA typing information available. In 312 
      donor-recipient pairs, typing at serological split antigen level was available. 
      We used the Epitope MisMatch Algorithm to calculate the number of amino acid 
      differences in antibody-verified HLA eplets (amino acid mismatch load (AAMM)) 
      between donor and recipient. Patients with a higher HLA-DR AAMM load had inferior 
      1-year graft survival (hazard ratio [HR], 1.14; 95% confidence interval [CI], 
      1.01-1.28). The HLA-AB AAMM load showed no impact on graft survival. In the 
      subgroup with available split-level information, we observed an inferior graft 
      survival for a higher HLA-DR AAMM load 3 months after transplantation (HR, 1.22; 
      95% CI, 1.04-1.44) and a higher risk for rejection for an increasing HLA-AB (HR, 
      1.70; 95% CI, 1.29-2.24) and HLA-DR (HR, 1.32; 95% CI, 1.09-1.61) AAMM load. No 
      impact on the development of CAV was found. Molecular-level HLA mismatch analysis 
      could serve as a tool for risk stratification after heart transplantation and 
      might take us one step further into precision medicine.
CI  - (c) 2020 The Authors. Transplant International published by John Wiley & Sons Ltd 
      on behalf of Steunstichting ESOT.
FAU - Osorio-Jaramillo, Emilio
AU  - Osorio-Jaramillo E
AUID- ORCID: 0000-0002-2549-8816
AD  - Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
FAU - Haasnoot, Geert W
AU  - Haasnoot GW
AD  - Department of Immunohematology and Blood Transfusion, Leiden University Medical 
      Center, Leiden, The Netherlands.
FAU - Kaider, Alexandra
AU  - Kaider A
AD  - Center for Medical Statistics, Informatics and Intelligent Systems, Medical 
      University of Vienna, Vienna, Austria.
FAU - Schaefer, Anne-Kristin
AU  - Schaefer AK
AD  - Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
FAU - Haberl, Thomas
AU  - Haberl T
AUID- ORCID: 0000-0003-1370-0746
AD  - Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
FAU - Goekler, Johannes
AU  - Goekler J
AUID- ORCID: 0000-0003-4509-2482
AD  - Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
FAU - Angleitner, Philipp
AU  - Angleitner P
AUID- ORCID: 0000-0002-8378-0633
AD  - Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
FAU - Moayedifar, Roxana
AU  - Moayedifar R
AD  - Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
FAU - Zuckermann, Andreas
AU  - Zuckermann A
AUID- ORCID: 0000-0002-8054-8150
AD  - Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
FAU - Fischer, Gottfried F
AU  - Fischer GF
AUID- ORCID: 0000-0002-3442-3680
AD  - Department for Blood Group Serology and Transfusion Medicine, Medical University 
      of Vienna, Vienna, Austria.
FAU - Laufer, Guenther
AU  - Laufer G
AUID- ORCID: 0000-0001-7257-110X
AD  - Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
FAU - Claas, Frans H J
AU  - Claas FHJ
AUID- ORCID: 0000-0003-4157-6201
AD  - Department of Immunohematology and Blood Transfusion, Leiden University Medical 
      Center, Leiden, The Netherlands.
AD  - Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, 
      Antwerp, Belgium.
FAU - Aliabadi-Zuckermann, Arezu Z
AU  - Aliabadi-Zuckermann AZ
AUID- ORCID: 0000-0002-2808-7158
AD  - Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
LA  - eng
PT  - Journal Article
DEP - 20200623
PL  - Switzerland
TA  - Transpl Int
JT  - Transplant international : official journal of the European Society for Organ 
      Transplantation
JID - 8908516
RN  - 0 (HLA Antigens)
SB  - IM
CIN - Transpl Int. 2020 Nov;33(11):1551-1552. PMID: 32652652
MH  - Graft Rejection
MH  - *Graft Survival
MH  - HLA Antigens
MH  - *Heart Transplantation
MH  - Histocompatibility Testing
MH  - Humans
MH  - Retrospective Studies
PMC - PMC7540475
OTO - NOTNLM
OT  - allograft rejection
OT  - antibody-verified HLA eplets
OT  - cardiac allograft vasculopathy
OT  - graft survival
OT  - heart transplantation
OT  - precision medicine
COIS- The authors declare no conflicts of interest.
EDAT- 2020/05/23 06:00
MHDA- 2021/06/25 06:00
PMCR- 2020/10/07
CRDT- 2020/05/23 06:00
PHST- 2020/02/04 00:00 [received]
PHST- 2020/03/10 00:00 [revised]
PHST- 2020/05/15 00:00 [accepted]
PHST- 2020/05/23 06:00 [pubmed]
PHST- 2021/06/25 06:00 [medline]
PHST- 2020/05/23 06:00 [entrez]
PHST- 2020/10/07 00:00 [pmc-release]
AID - TRI13657 [pii]
AID - 10.1111/tri.13657 [doi]
PST - ppublish
SO  - Transpl Int. 2020 Sep;33(9):1078-1088. doi: 10.1111/tri.13657. Epub 2020 Jun 23.