Clinical Lung and Heart/Lung TransplantationDoes human leukocyte antigen matching influence the outcome of lung transplantation? an analysis of 3,549 lung transplantations
Section snippets
Patients and methods
The initial study cohort included 4,782 adult cadaveric lung transplant recipients operated on between October 1987 and June 1997. Data were retrieved from the United Network for Organ Sharing/International Society for Heart and Lung Transplantation registry. Exclusion criteria included incomplete HLA data (n = 807), pediatric recipients (n = 264), non-cadaveric donors (n = 82), inadequate or insufficient survival data (n = 73), and multiorgan transplants (n = 7), thus providing complete data
Results
The distribution of the total number of HLA mismatches is illustrated in Table I. Only 4.6% of the patients in this study (164/3,549) had 0, 1, or 2 total mismatches.
The actuarial survival of lung transplantation patients according to the total number of HLA mismatches and the number of mismatches at the HLA-A, HLA-B, and HLA-DR loci are shown in Figure 1 and Figure 2. We found a significant difference in survival when transplants were stratified by either the total mismatch level (p =
Discussion
The results of this study, examining a large cohort of patients who underwent lung transplantation, indicated that HLA matching does not have an important clinical impact on outcome after transplantation. This is in contrast with both renal and cardiac transplantation, in which HLA matching has a beneficial effect on outcome.1, 3 In this study univariate analyses indicated that 2 or fewer total HLA mismatches or limited mismatching at the HLA-A locus were associated statistically with an
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