What question did this study set out to answer?

To determine how HLA-A, HLA-B, and HLA-DR histocompatibility mismatches affect graft rejection frequency and long-term graft survival following orthotopic heart transplantation.

August 1, 1999Transplantation

The Influence of Histocompatibility on Graft Rejection and Graft Survival Within a Single Center Population of Heart Transplant Recipients

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Authors

SSSally SheldonKent State University NYNizar YonanNewcastle upon Tyne Hospitals NHS Foundation Trust TATahir AzizHazara University

Discussion

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Implication

Cohort study shows that HLA-A, -B, and -DR mismatches reduce graft survival and increase rejection in heart transplant recipients, highlighting the need to minimize histocompatibility mismatches.

Key Points

To determine how HLA-A, HLA-B, and HLA-DR histocompatibility mismatches affect graft rejection frequency and long-term graft survival following orthotopic heart transplantation.
Analyzed a consecutive single-center cohort of 261 patients who received a first orthotopic heart transplant between 1986 and 1997.
Evaluated actuarial graft survival and the frequency of treated rejection episodes stratified by cumulative HLA-A, HLA-B, and HLA-DR mismatch counts over follow-up periods up to 7 years.
Four HLA-A+-B mismatches significantly lowered 6-month actuarial graft survival compared with 0–3 mismatches (69% [n=68] vs 85% [n=193]; OR=2.1, P=0.005), and having six combined HLA mismatches reduced 7-year survival (47% vs 64%).
Among 182 recipients with functioning grafts at 1 year, the number of treated rejection episodes increased with HLA-DR mismatches (mean 1.2 episodes for 0 mismatches [n=15] vs 2.7 for 1 mismatch [n=76] vs 3.8 for 2 mismatches [n=91]; P=0.0002).
Recipients experiencing >4 rejection episodes in the first year had significantly decreased 7-year graft survival (66% [n=49] vs 85% for <5 episodes [n=133]; OR=3.4, P=0.02), as did patients with two HLA-DR mismatches (70% [n=91] vs 87% for 0–1 mismatch [n=91]; OR=2.4, P<0.05).

Cite This Study

Sheldon et al. (1999) studied this question.

synapsesocial.com/papers/6a110a73e2199439c8f33071 https://doi.org/10.1097/00007890-199908270-00012

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August 1, 1999Transplantation

The Influence of Histocompatibility on Graft Rejection and Graft Survival Within a Single Center Population of Heart Transplant Recipients

View Full Paper

Ask AI

Bookmark

Authors

SSSally SheldonKent State University NYNizar YonanNewcastle upon Tyne Hospitals NHS Foundation Trust TATahir AzizHazara University

Discussion

Member takes

Implication

Cohort study shows that HLA-A, -B, and -DR mismatches reduce graft survival and increase rejection in heart transplant recipients, highlighting the need to minimize histocompatibility mismatches.

Key Points

To determine how HLA-A, HLA-B, and HLA-DR histocompatibility mismatches affect graft rejection frequency and long-term graft survival following orthotopic heart transplantation.
Analyzed a consecutive single-center cohort of 261 patients who received a first orthotopic heart transplant between 1986 and 1997.
Evaluated actuarial graft survival and the frequency of treated rejection episodes stratified by cumulative HLA-A, HLA-B, and HLA-DR mismatch counts over follow-up periods up to 7 years.
Four HLA-A+-B mismatches significantly lowered 6-month actuarial graft survival compared with 0–3 mismatches (69% [n=68] vs 85% [n=193]; OR=2.1, P=0.005), and having six combined HLA mismatches reduced 7-year survival (47% vs 64%).
Among 182 recipients with functioning grafts at 1 year, the number of treated rejection episodes increased with HLA-DR mismatches (mean 1.2 episodes for 0 mismatches [n=15] vs 2.7 for 1 mismatch [n=76] vs 3.8 for 2 mismatches [n=91]; P=0.0002).
Recipients experiencing >4 rejection episodes in the first year had significantly decreased 7-year graft survival (66% [n=49] vs 85% for <5 episodes [n=133]; OR=3.4, P=0.02), as did patients with two HLA-DR mismatches (70% [n=91] vs 87% for 0–1 mismatch [n=91]; OR=2.4, P<0.05).

Cite This Study

Sheldon et al. (1999) studied this question.

synapsesocial.com/papers/6a110a73e2199439c8f33071 https://doi.org/10.1097/00007890-199908270-00012

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