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The influence of human leukocyte antigen matching on outcomes in pediatric heart transplantation. Pediatr Cardiol 2014 Aug;35(6):1020-3 PMID: 24756223

Abstract

Previous adult heart transplantation studies have demonstrated that donor-recipient human leukocyte antigen (HLA) matching results in reduced graft failure and improved patient survival. No study has examined these effects in children. This study investigated the effect of HLA matching on outcomes in pediatric heart transplantation. All pediatric heart transplantation data for patients 0-18 years of age available from the United Network for Organ Sharing Transplant Registry from 1987 to 2009 were analyzed retrospectively. Donor-recipient HLA matching at loci A, B, and DR (0-6) was compared with graft survival and recipient survival. For this study, 3,751 pediatric cardiac transplantation events with complete HLA matching data were identified and grouped as having 0 to 2 matches (3,416 events) or 3 to 6 matches (335 events). The 3- to 6-match group had less graft failure than the 0- to 2-match group (28.7% vs 34.4%; p = 0.035) and greater patient survival by 5 years (81% vs 72%; p = 0.045) and 10 years (66% vs 55%; p = 0.005) after transplantation. The HLA-DR matching alone resulted in less graft failure (p = 0.038) and improved patient survival (p = 0.017). A higher degree of HLA matching in pediatric heart transplantation is associated with decreased graft failure and improved patient survival. In this study, decreased graft failure rates and superior survival also were seen with DR matching alone.

Author List

Ginde S, Ellis TM, Nugent M, Simpson P, Stendahl G, Berger S, Zangwill S

Authors

Salil Ginde MD, MPH Assistant Professor in the Pediatrics department at Medical College of Wisconsin
Pippa M. Simpson PhD Chief, Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Child, Preschool
Female
Graft Survival
HLA Antigens
Heart Diseases
Heart Transplantation
Histocompatibility
Histocompatibility Testing
Humans
Infant, Newborn
Male
Outcome Assessment (Health Care)
Proportional Hazards Models
Registries
Retrospective Studies
United States



View this publication's entry at the Pubmed website PMID: 24756223
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