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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
5
|
| pubmed:dateCreated |
1993-12-23
|
| pubmed:abstractText |
To determine whether immunosuppressive prophylaxis reduces the effect of HLA-DR incompatibility on rejection, we compared clinical and immunologic variables of patients given horse antithymocyte globulin, OKT3, or no immunosuppressive prophylaxis. Median follow-up was 27 months. Groups were similar in race; preoperative HLA reactivity; ABO matching; number of HLA-A, -B, -C, and -DR mismatches; and rejection severity. Patients given immunosuppressive prophylaxis were younger (p = 0.04), had a greater frequency of preoperative ischemic disease (p = 0.03), and had a higher 6-month rejection rate (p = 0.02). A highly significant association was found between the number of mismatches at the HLA-DR locus and rejection severity (p = 0.005). Within the OKT3-based immunosuppressive prophylaxis group and the no immunosuppressive prophylaxis group a significant association was found between the number of HLA-DR mismatches and rejection severity (p = 0.01 and p = 0.009, respectively). A similar trend was identified in the group given horse antithymocyte globulin-based immunosuppressive prophylaxis. Logistic regression, used to identify independent predictors of rejection, showed that the number of HLA-DR mismatches and not the use or type of immunosuppressive prophylaxis is significantly associated with rejection (p = 0.0009). One-year patient survival was 83% in the group with two HLA-DR mismatches and 85% in the group with one or no HLA-DR mismatch. Thus the lower rejection rates in patients with one or no HLA-DR mismatch were not associated with a 1-year survival, which was better than that of patients with two HLA-DR mismatches. The potential benefit of HLA-DR matching on rejection and patient survival must be confirmed by larger prospective studies.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:chemical |
http://linkedlifedata.com/resource/pubmed/chemical/Antilymphocyte Serum,
http://linkedlifedata.com/resource/pubmed/chemical/Azathioprine,
http://linkedlifedata.com/resource/pubmed/chemical/Cyclosporine,
http://linkedlifedata.com/resource/pubmed/chemical/HLA-DR Antigens,
http://linkedlifedata.com/resource/pubmed/chemical/Immunosuppressive Agents,
http://linkedlifedata.com/resource/pubmed/chemical/Methylprednisolone,
http://linkedlifedata.com/resource/pubmed/chemical/Muromonab-CD3,
http://linkedlifedata.com/resource/pubmed/chemical/Prednisone
|
| pubmed:status |
MEDLINE
|
| pubmed:issn |
1053-2498
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
12
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
779-89
|
| pubmed:dateRevised |
2004-11-17
|
| pubmed:meshHeading |
pubmed-meshheading:8241215-Adolescent,
pubmed-meshheading:8241215-Adult,
pubmed-meshheading:8241215-Aged,
pubmed-meshheading:8241215-Antilymphocyte Serum,
pubmed-meshheading:8241215-Azathioprine,
pubmed-meshheading:8241215-Child,
pubmed-meshheading:8241215-Cyclosporine,
pubmed-meshheading:8241215-Cytomegalovirus Infections,
pubmed-meshheading:8241215-Female,
pubmed-meshheading:8241215-Forecasting,
pubmed-meshheading:8241215-Graft Rejection,
pubmed-meshheading:8241215-HLA-DR Antigens,
pubmed-meshheading:8241215-Heart Transplantation,
pubmed-meshheading:8241215-Histocompatibility,
pubmed-meshheading:8241215-Humans,
pubmed-meshheading:8241215-Immunosuppressive Agents,
pubmed-meshheading:8241215-Male,
pubmed-meshheading:8241215-Methylprednisolone,
pubmed-meshheading:8241215-Middle Aged,
pubmed-meshheading:8241215-Muromonab-CD3,
pubmed-meshheading:8241215-Prednisone,
pubmed-meshheading:8241215-Survival Rate
|
| pubmed:articleTitle |
HLA-DR incompatibility predicts heart transplant rejection independent of immunosuppressive prophylaxis.
|
| pubmed:affiliation |
Department of Medicine, Loyola University Chicago, Maywood, Ill. 60153.
|
| pubmed:publicationType |
Journal Article
|