title: Impact of virtual cross match on waiting times for heart transplantation.
abstract: BACKGROUND
  Heart transplantation for sensitized patients has been a significant challenge. In this study, outcome of heart transplantation in sensitized patients with virtual cross match was compared with prospective cross match.
  
  
  METHODS
  Prior to July 2007, prospective cross match was used and afterward, virtual cross match with Luminex (One Lambda, Inc, Canoga Park, CA) based antibody analysis was used for potential heart transplant recipients. Prospectively collected data for the 3 years before and after July 2007, in sensitized (panel reactive antibody greater than 10%) and nonsensitized heart transplant recipients were reviewed.
  
  
  RESULTS
  One hundred sixty-eight patients met inclusion criteria for analysis (78 patients for prospective cross match and 90 patients for virtual cross match). Multiple parameters were compared for the prospective cross match and virtual cross match eras. Three-year survivals in nonsensitized patients were 84.6% and 77.2% and in sensitized patients were 76.9% and 77.4% (p = 0.49) for prospective cross match and virtual cross match eras, respectively. Freedom from 3A (2R) cellular rejection in nonsensitized patients was 96.9% and 95.3%, and in sensitized patients was 90.9% and 100% (p = 0.83). Freedom from antibody-mediated rejection in nonsensitized patients was 95.3% and 96.8%, and in sensitized patients was 90.9% and 90.5% (p = 0.65). Mean waiting time was 129 ± 246 days (mean ± SD) for the period before virtual cross match and 59 ± 78 days with virtual cross match (p = 0.018). Donor geographic area was similar for prospective and virtual cross match.
  
  
  CONCLUSIONS
  In sensitized heart transplant candidates, virtual cross match may shorten waiting time to heart transplantation without increasing subsequent occurrence of cellular rejection, antibody mediated rejection, and mortality after heart transplantation.
authors: Division of Cardiothoracic Surgery, Cedars-Sinai Heart Institute, Los Angeles, California, USA. ryanagida@att.net
authors: Roh
authors: R
authors: Yanagida
authors: Lawrence S C
authors: LS
authors: Czer
authors: Nancy L
authors: NL
authors: Reinsmoen
authors: Kai
authors: K
authors: Cao
authors: Matthew
authors: M
authors: Rafiei
authors: Michele A
authors: MA
authors: De Robertis
authors: James
authors: J
authors: Mirocha
authors: Robert M
authors: RM
authors: Kass
authors: Jon A
authors: JA
authors: Kobashigawa
authors: Alfredo
authors: A
authors: Trento
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006084:Graft Rejection; D016027:Heart Transplantation / Q000401:mortality; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D014850:Waiting Lists