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Impact of HLA compatibility on lung transplant survival and evidence for an HLA restriction phenomenon: a collaborative transplant study report

Background. - Data concerning the impact of human leukocyte antigen (HLA) compatibility on lung transplant survival rates are limited. - Methods. - Using the Collaborative Transplant Study database, 5-year graft outcome according to HLA mismatch was examined in 8020 deceased donor lung transplants p...

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Hauptverfasser: Opelz, Gerhard (VerfasserIn) , Süsal, Caner (VerfasserIn) , Ruhenstroth, Andrea (VerfasserIn) , Döhler, Bernd (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2010
In: Transplantation
Year: 2010, Jahrgang: 90, Heft: 8, Pages: 912-917
ISSN:1534-6080
DOI:10.1097/TP.0b013e3181f2c981
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1097/TP.0b013e3181f2c981
Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/transplantjournal/Fulltext/2010/10270/Impact_of_HLA_Compatibility_on_Lung_Transplant.17.aspx
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Verfasserangaben:Gerhard Opelz, Caner Süsal, Andrea Ruhenstroth, and Bernd Döhler

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520 |a Background. - Data concerning the impact of human leukocyte antigen (HLA) compatibility on lung transplant survival rates are limited. - Methods. - Using the Collaborative Transplant Study database, 5-year graft outcome according to HLA mismatch was examined in 8020 deceased donor lung transplants performed during 1989 to 2009. - Results. - Graft survival rates showed a stepwise decrease as the combined number of HLA-A+B+DR mismatches increased from one to six (P<0.001). Surprisingly, the 28 grafts with 0 mismatches at all 3 loci had a 1-year survival rate of only 49.7%, significantly lower than for 1, 2, 3, 4, 5, or 6 mismatches (P=0.002, <0.001, <0.001, <0.001, 0.002, and 0.003, respectively). Multivariate regression analysis confirmed that, paradoxically, transplantation of grafts with zero HLA-A+B+DR mismatches was associated with a 19% increase in relative risk of failure. Donor lung preservation for up to 12 hr was not associated with inferior graft survival versus shorter preservation times (P=0.60). - Conclusions. - Our data show that a high number of HLA mismatches or zero mismatches impacts unfavorably on lung transplant survival. 
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