The influence of human leukocyte antigen matching on outcomes in pediatric heart transplantation

Salil Ginde*, Thomas M. Ellis, Melodee Nugent, Pippa Simpson, Gail Stendahl, Stuart Berger, Steven Zangwill

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1020-1023
Number of pages4
JournalPediatric Cardiology
Volume35
Issue number6
DOIs
StatePublished - Jan 1 2014

Keywords

  • Human leukoctye antigen
  • Pediatric heart transplantation
  • Transplant rejection

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

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