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Relative impact of human leukocyte antigen mismatching and graft ischemic time after lung transplantation.
J Heart Lung Transplant. 2008 Jun; 27(6):628-34.JH

Abstract

BACKGROUND

Recent data strongly suggest that human leukocyte antigen (HLA) mismatching has a negative impact on development of bronchiolitis obliterans syndrome (BOS) and survival after lung transplantation (LTx). Because HLA matching is sometimes achieved by extending ischemic time in other solid-organ transplantation models and ischemic time is a risk factor per se for death after LTx, we sought to compare the theoretical benefit of HLA matching with the negative impact of lengthened ischemic time.

METHODS

In this collaborative study we compared the relative impact of HLA mismatching and ischemic time on BOS and survival in 182 LTx recipients.

RESULTS

Using multivariate analyses, we observed a lower incidence of BOS (hazard ratio [HR] = 1.70, 95% confidence interval [CI]: 1.1 to 2.7, p = 0.03) and enhanced survival (HR = 1.91, 95% CI: 1.24 to 2.92, p = 0.01) in patients with zero or one HLA-A mismatch compared with those having two HLA-A mismatches. This beneficial effect on survival was equivalent to a reduction of ischemic time of 168 minutes.

CONCLUSIONS

We observed a reduced incidence of BOS and a better survival rate in patients well-matched at the HLA-A locus, associated with an opposite effect of an enhanced ischemic time. This suggests that graft ischemic time should be taken into account in future studies of prospective HLA matching in LTx.

Authors+Show Affiliations

Hôpital Bichat, Paris, France. olivier.brugiere@bch.aphp.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18503962

Citation

Brugière, Olivier, et al. "Relative Impact of Human Leukocyte Antigen Mismatching and Graft Ischemic Time After Lung Transplantation." The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, vol. 27, no. 6, 2008, pp. 628-34.
Brugière O, Thabut G, Suberbielle C, et al. Relative impact of human leukocyte antigen mismatching and graft ischemic time after lung transplantation. J Heart Lung Transplant. 2008;27(6):628-34.
Brugière, O., Thabut, G., Suberbielle, C., Reynaud-Gaubert, M., Thomas, P., Pison, C., Saint Raymond, C., Mornex, J. F., Bertocchi, M., Dromer, C., Velly, J. F., Stern, M., Philippe, B., Dauriat, G., Biondi, G., Castier, Y., & Fournier, M. (2008). Relative impact of human leukocyte antigen mismatching and graft ischemic time after lung transplantation. The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, 27(6), 628-34. https://doi.org/10.1016/j.healun.2008.02.013
Brugière O, et al. Relative Impact of Human Leukocyte Antigen Mismatching and Graft Ischemic Time After Lung Transplantation. J Heart Lung Transplant. 2008;27(6):628-34. PubMed PMID: 18503962.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relative impact of human leukocyte antigen mismatching and graft ischemic time after lung transplantation. AU - Brugière,Olivier, AU - Thabut,Gabriel, AU - Suberbielle,Caroline, AU - Reynaud-Gaubert,Martine, AU - Thomas,Pascal, AU - Pison,Christophe, AU - Saint Raymond,Christel, AU - Mornex,Jean-François, AU - Bertocchi,Michèle, AU - Dromer,Claire, AU - Velly,Jean-François, AU - Stern,Marc, AU - Philippe,Bruno, AU - Dauriat,Gaëlle, AU - Biondi,Giuseppina, AU - Castier,Yves, AU - Fournier,Michel, PY - 2007/11/16/received PY - 2008/02/08/revised PY - 2008/02/17/accepted PY - 2008/5/28/pubmed PY - 2008/7/23/medline PY - 2008/5/28/entrez SP - 628 EP - 34 JF - The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation JO - J. Heart Lung Transplant. VL - 27 IS - 6 N2 - BACKGROUND: Recent data strongly suggest that human leukocyte antigen (HLA) mismatching has a negative impact on development of bronchiolitis obliterans syndrome (BOS) and survival after lung transplantation (LTx). Because HLA matching is sometimes achieved by extending ischemic time in other solid-organ transplantation models and ischemic time is a risk factor per se for death after LTx, we sought to compare the theoretical benefit of HLA matching with the negative impact of lengthened ischemic time. METHODS: In this collaborative study we compared the relative impact of HLA mismatching and ischemic time on BOS and survival in 182 LTx recipients. RESULTS: Using multivariate analyses, we observed a lower incidence of BOS (hazard ratio [HR] = 1.70, 95% confidence interval [CI]: 1.1 to 2.7, p = 0.03) and enhanced survival (HR = 1.91, 95% CI: 1.24 to 2.92, p = 0.01) in patients with zero or one HLA-A mismatch compared with those having two HLA-A mismatches. This beneficial effect on survival was equivalent to a reduction of ischemic time of 168 minutes. CONCLUSIONS: We observed a reduced incidence of BOS and a better survival rate in patients well-matched at the HLA-A locus, associated with an opposite effect of an enhanced ischemic time. This suggests that graft ischemic time should be taken into account in future studies of prospective HLA matching in LTx. SN - 1557-3117 UR - https://www.unboundmedicine.com/medline/citation/18503962/Relative_impact_of_human_leukocyte_antigen_mismatching_and_graft_ischemic_time_after_lung_transplantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1053-2498(08)00182-4 DB - PRIME DP - Unbound Medicine ER -