The impact of HLA-DR mismatch status on retransplant-free survival and bronchiolitis obliterans syndrome‒free survival among sensitized lung transplant recipients
Section snippets
Study design
This study used data from the Scientific Registry of Transplant Recipients (SRTR). The SRTR data system includes data on all donors, wait-listed candidates, and transplant recipients in the United States (US), submitted by the members of the Organ Procurement and Transplantation Network. The Health Resources and Services Administration of the US Department of Health and Human Services provides oversight to the activities of the Organ Procurement and Transplantation Network and SRTR contractors.
Study cohort
Among the 24,891 adult recipients who underwent first transplantation in the study years, 2,121 (10.4%) were excluded for having no CPRA data, and 2,415 (9.7%) were excluded for having no DR data, leaving 20,355 recipients in the final study cohort. A total of 7,259 recipients (35.7%) were sensitized (CPRA of >0%), and 526 (2.6%) were highly sensitized (CPRA of ≥80%). Both sensitized and highly sensitized recipients were more likely to be female, to be non-White, to have had prior pregnancies,
Discussion
Previous studies have suggested that donor‒recipient HLA-DR locus matching may be protective against BOS in lung transplant recipients, but it is unknown whether this benefit is more pronounced for sensitized and highly sensitized recipients. Our primary findings were that first, although 0 donor‒recipient HLA-DR mismatches are associated with improved retransplant-free survival and BOS1-free and BOS3-free survival among all lung transplant recipients, this effect is not more pronounced in
Conclusions
HLA-DR matching does not offer an added benefit with regard to retransplant-free or BOS-free survival for sensitized lung transplant recipients compared with non-sensitized recipients. HLA-DR matching is not associated with improved retransplant-free or BOS-free survival or relevant rejection-related outcomes among highly sensitized recipients.
Disclosure statement
The authors have no conflicts of interest to disclose.
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