PMID- 38232791
OWN - NLM
STAT- MEDLINE
DCOM- 20240505
LR  - 20240510
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 43
IP  - 5
DP  - 2024 May
TI  - DQB1 antigen matching improves rejection-free survival in pediatric heart 
      transplant recipients.
PG  - 816-825
LID - S1053-2498(24)00012-3 [pii]
LID - 10.1016/j.healun.2024.01.008 [doi]
AB  - BACKGROUND: Presence of donor-specific antibodies (DSAs), particularly to class 
      II antigens, remains a major challenge in pediatric heart transplantation. 
      Donor-recipient human leukocyte antigen (HLA) matching is a potential strategy to 
      mitigate poor outcomes associated with DSAs. We evaluated the hypothesis that 
      antigen mismatching at the DQB1 locus is associated with worse rejection-free 
      survival. METHODS: Data were collected from Scientific Registry of Transplant 
      Recipients for all pediatric heart transplant recipients 2010-2021. Only 
      transplants with complete HLA typing at the DQB1 locus for recipient and donor 
      were included. Primary outcome was rejection-free graft survival through 5 years. 
      RESULTS: Of 5,115 children, 4,135 had complete DQB1 typing and were included. Of 
      those, 503 (12%) had 0 DQB1 donor-recipient mismatches, 2,203 (53%) had 1, and 
      1,429 (35%) had 2. Rejection-free survival through 5 years trended higher for 
      children with 0 DQB1 mismatches (68%), compared to those with 1 (62%) or 2 (63%) 
      mismatches (pairwise p = 0.08 for both). In multivariable analysis, 0 DQB1 
      mismatches remained significantly associated with improved rejection-free graft 
      survival compared to 2 mismatches, while 1 DQB1 mismatch was not. Subgroup 
      analysis showed the strongest effect in non-Hispanic Black children and those 
      undergoing retransplant. CONCLUSIONS: Matching at the DQB1 locus is associated 
      with improved rejection-free survival after pediatric heart transplant, 
      particularly in Black children, and those undergoing retransplant. Assessing 
      high-resolution donor typing at the time of allocation may further corroborate 
      and refine this association. DQB1 matching may improve long-term outcomes in 
      children stabilized either with optimal pharmacotherapy or supported with durable 
      devices able to await ideal donors.
CI  - Copyright (c) 2024 International Society for the Heart and Lung Transplantation. 
      Published by Elsevier Inc. All rights reserved.
FAU - Wright, Lydia K
AU  - Wright LK
AD  - The Heart Center, Nationwide Children's Hospital, Department of Pediatrics, The 
      Ohio State University, Columbus, Ohio. Electronic address: 
      Lydia.wright@nationwidechildrens.org.
FAU - Gajarski, Robert J
AU  - Gajarski RJ
AD  - The Heart Center, Nationwide Children's Hospital, Department of Pediatrics, The 
      Ohio State University, Columbus, Ohio.
FAU - Hayes, Emily
AU  - Hayes E
AD  - The Heart Center, Nationwide Children's Hospital, Department of Pediatrics, The 
      Ohio State University, Columbus, Ohio.
FAU - Parekh, Hemant
AU  - Parekh H
AD  - Clinical Histocompatibility Laboratory, The Ohio State University, Columbus, 
      Ohio.
FAU - Yester, Jessie W
AU  - Yester JW
AD  - The Heart Center, Nationwide Children's Hospital, Department of Pediatrics, The 
      Ohio State University, Columbus, Ohio.
FAU - Nandi, Deipanjan
AU  - Nandi D
AD  - The Heart Center, Nationwide Children's Hospital, Department of Pediatrics, The 
      Ohio State University, Columbus, Ohio.
LA  - eng
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20240115
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 (HLA-DQ beta-Chains)
RN  - 0 (HLA-DQB1 antigen)
SB  - IM
MH  - Humans
MH  - *Heart Transplantation
MH  - Male
MH  - Child
MH  - Female
MH  - *Graft Rejection/immunology
MH  - *Graft Survival/immunology
MH  - Child, Preschool
MH  - *HLA-DQ beta-Chains/genetics
MH  - Infant
MH  - Histocompatibility Testing/methods
MH  - Adolescent
MH  - Retrospective Studies
MH  - Tissue Donors
MH  - Registries
MH  - Transplant Recipients
OTO - NOTNLM
OT  - HLA matching
OT  - antibody-mediated rejection
OT  - disparities
OT  - pediatric heart transplant
OT  - rejection
EDAT- 2024/01/18 00:42
MHDA- 2024/05/06 00:52
CRDT- 2024/01/17 19:11
PHST- 2023/08/21 00:00 [received]
PHST- 2024/01/05 00:00 [revised]
PHST- 2024/01/09 00:00 [accepted]
PHST- 2024/05/06 00:52 [medline]
PHST- 2024/01/18 00:42 [pubmed]
PHST- 2024/01/17 19:11 [entrez]
AID - S1053-2498(24)00012-3 [pii]
AID - 10.1016/j.healun.2024.01.008 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2024 May;43(5):816-825. doi: 
      10.1016/j.healun.2024.01.008. Epub 2024 Jan 15.