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Human Leukocyte Antigen Matching in Heart Transplantation: Systematic Review and Meta-analysis.

Ansari, David LU ; Bućin, Dragan and Nilsson, Johan LU (2014) In Transplant International 27(8). p.793-804
Abstract
Allocation of donors with regard to human leukocyte antigen (HLA) is controversial in heart transplantation. This paper is a systematic review and meta-analysis of the available evidence. PubMed, Embase, and the Cochrane Library were searched systematically for studies that addressed the effects of HLA matching on outcome after heart transplantation. Fifty-seven studies met the eligibility criteria. 34 studies had graft rejection as outcome, with 26 of the studies reporting a significant reduction in graft rejection with increasing degree of HLA matching. Thirteen of 18 articles that reported on graft failure found that it decreased significantly with increasing HLA match. Two multicenter studies and 9 single-center studies provided... (More)
Allocation of donors with regard to human leukocyte antigen (HLA) is controversial in heart transplantation. This paper is a systematic review and meta-analysis of the available evidence. PubMed, Embase, and the Cochrane Library were searched systematically for studies that addressed the effects of HLA matching on outcome after heart transplantation. Fifty-seven studies met the eligibility criteria. 34 studies had graft rejection as outcome, with 26 of the studies reporting a significant reduction in graft rejection with increasing degree of HLA matching. Thirteen of 18 articles that reported on graft failure found that it decreased significantly with increasing HLA match. Two multicenter studies and 9 single-center studies provided sufficient data to provide summary estimates at 12 months. Pooled comparisons showed that graft survival increased with fewer HLA-DR mismatches [0-1 vs. 2 mismatches: risk ratio (RR)=1.09 (95% confidence interval (CI): 1.01-1.19; P=0.04)]. Having fewer HLA-DR mismatches (0-1 vs. 2) reduced the incidence of acute rejection [(RR=0.81 (0.66-0.99; P=0.04)]. Despite the considerable heterogeneity between studies, the short observation time, and older data, HLA matching improves graft survival in heart transplantation. Prospective HLA-DR matching is clinically feasible and should be considered as a major selection criterion. This article is protected by copyright. All rights reserved. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Transplant International
volume
27
issue
8
pages
793 - 804
publisher
Springer
external identifiers
  • pmid:24725030
  • wos:000340184200010
  • scopus:84905060565
ISSN
1432-2277
DOI
10.1111/tri.12335
language
English
LU publication?
yes
id
cce83218-0a24-4fe1-bc3a-b5323497f723 (old id 4430293)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/24725030?dopt=Abstract
date added to LUP
2014-05-05 20:52:40
date last changed
2017-08-27 03:00:12
@article{cce83218-0a24-4fe1-bc3a-b5323497f723,
  abstract     = {Allocation of donors with regard to human leukocyte antigen (HLA) is controversial in heart transplantation. This paper is a systematic review and meta-analysis of the available evidence. PubMed, Embase, and the Cochrane Library were searched systematically for studies that addressed the effects of HLA matching on outcome after heart transplantation. Fifty-seven studies met the eligibility criteria. 34 studies had graft rejection as outcome, with 26 of the studies reporting a significant reduction in graft rejection with increasing degree of HLA matching. Thirteen of 18 articles that reported on graft failure found that it decreased significantly with increasing HLA match. Two multicenter studies and 9 single-center studies provided sufficient data to provide summary estimates at 12 months. Pooled comparisons showed that graft survival increased with fewer HLA-DR mismatches [0-1 vs. 2 mismatches: risk ratio (RR)=1.09 (95% confidence interval (CI): 1.01-1.19; P=0.04)]. Having fewer HLA-DR mismatches (0-1 vs. 2) reduced the incidence of acute rejection [(RR=0.81 (0.66-0.99; P=0.04)]. Despite the considerable heterogeneity between studies, the short observation time, and older data, HLA matching improves graft survival in heart transplantation. Prospective HLA-DR matching is clinically feasible and should be considered as a major selection criterion. This article is protected by copyright. All rights reserved.},
  author       = {Ansari, David and Bućin, Dragan and Nilsson, Johan},
  issn         = {1432-2277},
  language     = {eng},
  number       = {8},
  pages        = {793--804},
  publisher    = {Springer},
  series       = {Transplant International},
  title        = {Human Leukocyte Antigen Matching in Heart Transplantation: Systematic Review and Meta-analysis.},
  url          = {http://dx.doi.org/10.1111/tri.12335},
  volume       = {27},
  year         = {2014},
}