Implication of HLA mismatch in the clinical outcome of orthotopic heart transplantation.

THE benefit of matching donor organs and recipients for HLA polymorphism has been well established in kidney transplantation, and sharing of kidneys based on good histocompatibility matching is now a well-practiced international policy. However, because of poor preservation and short ischemic time tolerated by explanted hearts, HLA matching is rarely done in cardiac transplantation. The influence of HLA matching in the outcome of heart transplantation remains controversial as several studies have shown a relationship between HLA mismatch and survival, whereas other studies reporting correlation between HLA mismatch in the occurrence of cardiac allograft rejection. None of the previous studies reported the correlation between the degree of HLA mismatch and the graft function following transplantation. This study was designed to analyze the influence of HLA mismatch on cardiac allograft function, time to first rejection, number of rejection episodes experienced, and the implication of HLA mismatch in the long-term clinical outcome of orthotopic heart transplantation.