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Disproportionate HLA matching may contribute to racial disparity in patient survival following cardiac transplantation.
Clin Transplant. 1996 Dec; 10(6 Pt 2):625-8.CT

Abstract

The purpose of this study is to investigate the impact of recipient race as well as HLA matching upon long-term survival following heart transplantation (HTx). The study also determines whether the degree of HLA matching between Caucasians and African Americans differs. This study was a retrospective analysis of 336 males (77% Caucasians and 23% African Americans) transplanted between 1983 and 1994, all having received cyclosporine-based immunosuppression. The results showed African Americans were transplanted at a significantly younger age than Caucasians (39.1 +/- 11.2 vs. 48.2 +/- 10 yr). The composition of end stage cardiac disease was startlingly different. Caucasians demonstrated 62% CAD, 31% IDCM and 7% other, whereas African Americans exhibited 24% CAD, 69% IDCM and 7% other. The ten-year survival rate for African American male recipients was inferior to Caucasian males. Survival at 1, 3, 5, 7 and 9 yr was 83%, 73%, 63%, 51%, 46% for Caucasians and 70%, 58%, 51%, 38% and 32% for African Americans. Furthermore, African Americans received more poorly matched organs compared to Caucasians. Among Caucasians for Class I, 46%, 53% and 1% received poor, moderate and well matched hearts, respectively. In contrast, African American were allocated 65%, 33% and 0% of poor, moderate, or well matched hearts. An analysis of Class II data revealed the same pattern (63%, 35% 2% of Caucasians and 78%, 18%, and 4% of African Americans received poor, moderate or well matched hearts). Survival for Caucasians improved when moderately versus poorly matched for Class I. Class II matching did not have an effect. African Americans showed a similar trend, although statistical significance was not reached. When comparing equivalent degrees of matching, African Americans had inferior survival rate when poorly matched for Class I relative to Caucasians. No statistical difference was observed for moderate matched Class I or for Class II analysis.

Authors+Show Affiliations

Medical College of Virginia Hospital, Richmond 23298-0005, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

8996755

Citation

Park, M H., et al. "Disproportionate HLA Matching May Contribute to Racial Disparity in Patient Survival Following Cardiac Transplantation." Clinical Transplantation, vol. 10, no. 6 Pt 2, 1996, pp. 625-8.
Park MH, Tolman DE, Kimball PM. Disproportionate HLA matching may contribute to racial disparity in patient survival following cardiac transplantation. Clin Transplant. 1996;10(6 Pt 2):625-8.
Park, M. H., Tolman, D. E., & Kimball, P. M. (1996). Disproportionate HLA matching may contribute to racial disparity in patient survival following cardiac transplantation. Clinical Transplantation, 10(6 Pt 2), 625-8.
Park MH, Tolman DE, Kimball PM. Disproportionate HLA Matching May Contribute to Racial Disparity in Patient Survival Following Cardiac Transplantation. Clin Transplant. 1996;10(6 Pt 2):625-8. PubMed PMID: 8996755.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Disproportionate HLA matching may contribute to racial disparity in patient survival following cardiac transplantation. AU - Park,M H, AU - Tolman,D E, AU - Kimball,P M, PY - 1996/12/1/pubmed PY - 1996/12/1/medline PY - 1996/12/1/entrez SP - 625 EP - 8 JF - Clinical transplantation JO - Clin Transplant VL - 10 IS - 6 Pt 2 N2 - The purpose of this study is to investigate the impact of recipient race as well as HLA matching upon long-term survival following heart transplantation (HTx). The study also determines whether the degree of HLA matching between Caucasians and African Americans differs. This study was a retrospective analysis of 336 males (77% Caucasians and 23% African Americans) transplanted between 1983 and 1994, all having received cyclosporine-based immunosuppression. The results showed African Americans were transplanted at a significantly younger age than Caucasians (39.1 +/- 11.2 vs. 48.2 +/- 10 yr). The composition of end stage cardiac disease was startlingly different. Caucasians demonstrated 62% CAD, 31% IDCM and 7% other, whereas African Americans exhibited 24% CAD, 69% IDCM and 7% other. The ten-year survival rate for African American male recipients was inferior to Caucasian males. Survival at 1, 3, 5, 7 and 9 yr was 83%, 73%, 63%, 51%, 46% for Caucasians and 70%, 58%, 51%, 38% and 32% for African Americans. Furthermore, African Americans received more poorly matched organs compared to Caucasians. Among Caucasians for Class I, 46%, 53% and 1% received poor, moderate and well matched hearts, respectively. In contrast, African American were allocated 65%, 33% and 0% of poor, moderate, or well matched hearts. An analysis of Class II data revealed the same pattern (63%, 35% 2% of Caucasians and 78%, 18%, and 4% of African Americans received poor, moderate or well matched hearts). Survival for Caucasians improved when moderately versus poorly matched for Class I. Class II matching did not have an effect. African Americans showed a similar trend, although statistical significance was not reached. When comparing equivalent degrees of matching, African Americans had inferior survival rate when poorly matched for Class I relative to Caucasians. No statistical difference was observed for moderate matched Class I or for Class II analysis. SN - 0902-0063 UR - https://www.unboundmedicine.com/medline/citation/8996755/Disproportionate_HLA_matching_may_contribute_to_racial_disparity_in_patient_survival_following_cardiac_transplantation_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=8996755.ui DB - PRIME DP - Unbound Medicine ER -