PMID- 37422273
OWN - NLM
STAT- MEDLINE
DCOM- 20240219
LR  - 20240219
IS  - 1532-8414 (Electronic)
IS  - 1071-9164 (Linking)
VI  - 30
IP  - 2
DP  - 2024 Feb
TI  - Heart Transplant Human Leukocyte Antigen Matching in the Modern Era.
PG  - 362-372
LID - S1071-9164(23)00232-4 [pii]
LID - 10.1016/j.cardfail.2023.06.016 [doi]
AB  - BACKGROUND: Although numerous reports have studied the consequences of human 
      leukocyte antigen (HLA) mismatching in renal transplantation, there are limited 
      and outdated data analyzing this association in thoracic organ transplantation. 
      Therefore, our study reviewed the impact of HLA mismatching at both the total and 
      the loci levels in the modern-era heart-transplant procedure on survival and 
      chronic rejection outcomes. METHODS: We performed a retrospective analysis of 
      adult patients after heart transplant by using the United Network for Organ 
      Sharing database from January 2005-July 2021. Total HLA and HLA-A, HLA-B and 
      HLA-DR mismatches were analyzed. Survival and cardiac allograft vasculopathy were 
      the outcomes of interest during a 10-year follow-up period using Kaplan-Meier 
      curves, log-rank tests and multivariable regression models. RESULTS: A total of 
      33,060 patients were included in this study. Recipients with a high degree of HLA 
      mismatching had increased incidences of acute organ rejection. There were no 
      significant differences in mortality rates among any of the total or loci level 
      groups. Similarly, there were no significant differences between total HLA 
      mismatch groups in time to first cardiac allograft vasculopathy, though 
      mismatching at the HLA-DR locus was associated with an increased risk of cardiac 
      allograft vasculopathy. CONCLUSION: Our analysis suggests that HLA mismatch is 
      not a significant predictor of survival in the modern era. Overall, the clinical 
      implications of this study provide reassuring data for the continued use of 
      non-HLA-matched donors in an effort to increase the donor pool. If HLA matching 
      is to be considered for heart transplant donor-recipient selection, matching at 
      the HLA-DR locus should take priority due to its association with cardiac 
      allograft vasculopathy.
CI  - Copyright (c) 2023 Elsevier Inc. All rights reserved.
FAU - Firoz, Ahad
AU  - Firoz A
AD  - Lewis Katz School of Medicine at Temple University, Philadelphia PA. Electronic 
      address: ahad.firoz@temple.edu.
FAU - Geier, Steven
AU  - Geier S
AD  - Department of Pathology and Laboratory Medicine, Temple University Hospital, 
      Philadelphia PA.
FAU - Yanagida, Roh
AU  - Yanagida R
AD  - Department of Cardiovascular Surgery, Temple University Hospital, Philadelphia 
      PA.
FAU - Hamad, Eman
AU  - Hamad E
AD  - Heart and Vascular Institute, Temple University Hospital, Philadelphia PA.
FAU - Rakita, Val
AU  - Rakita V
AD  - Heart and Vascular Institute, Temple University Hospital, Philadelphia PA.
FAU - Zhao, Huaqing
AU  - Zhao H
AD  - Department of Biomedical Education and Data Science, Lewis Katz School of 
      Medicine, Philadelphia PA.
FAU - Kashem, Mohammed
AU  - Kashem M
AD  - Department of Cardiovascular Surgery, Temple University Hospital, Philadelphia 
      PA.
FAU - Toyoda, Yoshiya
AU  - Toyoda Y
AD  - Department of Cardiovascular Surgery, Temple University Hospital, Philadelphia 
      PA. Electronic address: yoshiya.toyoda@tuhs.temple.edu.
LA  - eng
PT  - Journal Article
DEP - 20230707
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
RN  - 0 (HLA-DR Antigens)
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adult
MH  - Humans
MH  - Retrospective Studies
MH  - Graft Survival
MH  - Graft Rejection/epidemiology
MH  - *Heart Failure
MH  - HLA-DR Antigens
MH  - HLA Antigens
MH  - *Heart Transplantation
OTO - NOTNLM
OT  - HLA
OT  - cardiac allograft vasculopathy
OT  - heart transplantation
OT  - survival
COIS- Disclosure YT reports clinical research and grant support from Transmedics, Cerus 
      Corporation ReciPe Study and EvaHeart, which had no relationship to the current 
      study and have not affected the integrity of our report.
EDAT- 2023/07/09 01:07
MHDA- 2024/02/19 06:42
CRDT- 2023/07/08 19:29
PHST- 2022/12/19 00:00 [received]
PHST- 2023/06/16 00:00 [revised]
PHST- 2023/06/20 00:00 [accepted]
PHST- 2024/02/19 06:42 [medline]
PHST- 2023/07/09 01:07 [pubmed]
PHST- 2023/07/08 19:29 [entrez]
AID - S1071-9164(23)00232-4 [pii]
AID - 10.1016/j.cardfail.2023.06.016 [doi]
PST - ppublish
SO  - J Card Fail. 2024 Feb;30(2):362-372. doi: 10.1016/j.cardfail.2023.06.016. Epub 
      2023 Jul 7.