Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2014 Dec;33(12):1282-7.
doi: 10.1016/j.healun.2014.07.014. Epub 2014 Jul 22.

Effect of human leukocyte antigen-C and -DQ matching on pediatric heart transplant graft survival

Affiliations
Comparative Study

Effect of human leukocyte antigen-C and -DQ matching on pediatric heart transplant graft survival

Ryan J Butts et al. J Heart Lung Transplant. 2014 Dec.

Abstract

Background: A higher degree of human leukocyte antigen (HLA) matching at the A, B, and DR loci has been associated with improved long-term survival after pediatric heart transplantation in multiple International Society for Heart and Lung Transplantation registry reports. The aim of this study was to investigate the association of HLA matching at the C and DQ loci with pediatric graft survival.

Methods: The United Network of Organ Sharing database was queried for isolated heart transplants that occurred from 1988 to 2012 with a recipient age of 17 or younger and at least 1 postoperative follow-up encounter. When HLA matching at the C or DQ loci were analyzed, only transplants with complete typing of donor and recipient at the respective loci were included. Transplants were divided into patients with at least 1 match at the C locus (C-match) vs no match (C-no), and at least 1 match at the DQ (DQ-match) locus vs no match (DQ-no). Primary outcome was graft loss. Univariate analysis was performed with the log-rank test. Cox regression analysis was performed with the following patient factors included in the model: recipient age, ischemic time; recipient on ventilator, extracorporeal membrane oxygenation, ventricular assist device, or inotropes at transplant; recipient serum bilirubin and creatinine closest to transplant, ratio of donor weight to recipient weight, underlying cardiac diagnosis, crossmatch results, transplant year, and HLA matching at the A, B, and DR loci.

Results: Complete typing at the C locus occurred in 2,429 of 4,731 transplants (51%), and complete typing at the DQ locus occurred in 3,498 of 4,731 transplants (74%). Patient factors were similar in C-match and C-no, except for year of transplant (median year, 2007 [interquartile range, 1997-2010] vs year 2005 [interquartile range, 1996-2009], respectively; p = 0.03) and the degree of HLA matching at the A, B, and DR loci (high level of HLA matching in 11.9% vs 3%, respectively; p < 0.01). Matching at the C locus was not associated with a decreased risk of graft loss (median graft survival: 13.1 years [95% confidence interval {CI}, 11.5-14.8] in C-no vs 15.1 years [95% CI, 13.5-16.6) in C-match, p = 0.44 log-rank; hazard ratio, 0.93; 95% CI, 0.76-1.15; p = 0.52). DQ-match did not differ from DQ-no in any of the analyzed patient factors, except DQ-match was more likely to have high degree of matching at the A, B, and DR loci vs DQ-no (9.8% vs 3.2%, p < 0.01). Matching at the DQ locus was not associated with decreased risk of graft loss (median graft survival: DQ-no, 13.1 years [95% CI, 11.7-14.6) vs DQ-match, 13.0 years [95% CI, 11.4-14.6], p = 0.80, log-rank; hazard ratio, 0.95; 95% CI, 0.81-1.1; p = 0.51.

Conclusions: Complete typing at the C locus of both donor and recipient occurs less often then typing at the DQ locus. A higher degree of donor-recipient HLA matching at the C locus or the DQ locus appears not to confer any graft survival advantage.

Keywords: C locus; DQ locus; allograft survival; human leukocyte antigen typing; pediatric heart transplant.

PubMed Disclaimer

Conflict of interest statement

Disclosures: No authors have relevant conflicts of interest to report.

Figures

Figure 1
Figure 1
Kaplan-Meier curve depicting graft survival between transplants with a match at HLA-C locus versus those with no match. Number at risk for each cohort at 5, 10, 15 and 20 years post-transplant are shown below the curve. There was no difference in graft survival. HLA-C-no:13.1 years (95%CI 11.5–14.8yrs) versus HLA-C-match: 15.1 years (95%CI 13.5–16.6yrs, p=0.44, log-rank test)
Figure 2
Figure 2
Kaplan-Meier curve depicting graft survival between transplants with a match at HLA-C locus versus those with no match. Number at risk for each cohort at 5, 10, 15 and 20 years post-transplant are shown below the curve. There was no difference in graft survival between HLA-DQ-no (median 13.1yrs, 95%CI 11.7–14.6yrs) versus HLA-DQ-match (median 13.0yrs, 95%CI 11.4–14.6, p=0.80, log-rank test)

Similar articles

Cited by

References

    1. Opelz G, Wujciak T. The influence of HLA compatibility on graft survival after heart transplantation. The Collaborative Transplant Study. N Engl J Med. 1994 Mar 24;330(12):816–819. - PubMed
    1. Opelz G, Wujciak T, Dohler B, Scherer S, Mytilineos J. HLA compatibility and organ transplant survival. Collaborative Transplant Study. Rev Immunogenet. 1999;1(3):334–342. - PubMed
    1. Kilic A, Weiss ES, Allen JG, et al. Simple score to assess the risk of rejection after orthotopic heart transplantation. Circulation. 2012 Jun 19;125(24):3013–3021. - PubMed
    1. Kaczmarek I, Deutsch MA, Rohrer ME, et al. HLA-DR matching improves survival after heart transplantation: is it time to change allocation policies? J Heart Lung Transplant. 2006 Sep;25(9):1057–1062. - PubMed
    1. Dipchand AI, Kirk R, Edwards LB, et al. The registry of the international society for heart and lung transplantation: sixteenth official pediatric heart transplantation report-2013; focus theme: age. J Heart Lung Transplant. 2013 Oct;32(10):979–988. - PubMed

Publication types