title: Human leukocyte antigen-DR13 and DR15 are associated with short-term lung transplant outcomes.
abstract: Lung transplantation outcomes are among the least favorable, with most recipients eventually developing bronchiolitis obliterans syndrome (BOS) and subsequent graft failure. The presence of human leukocyte antigen (HLA)-DR has been implicated in the pathogenesis of BOS and may play a role in these poor outcomes.
  
  
  
  Lung transplant donor and recipient data were retrospectively gathered from the United Network for Organ Sharing database from January 2006 to June 2013. Donor and recipient characteristics, proportion of recipients treated for first year rejection, and 5-y rates of survival and freedom from BOS were determined according to HLA-DR1, -DR7, -DR13, and -DR15 status in both donor and recipient. Each HLA-DR allele was stratified by donor-recipient pair positivity status.
  
  
  
  A total of 7402 lung transplant recipients met the inclusion and exclusion criteria. There were significant but small differences in donor and recipient characteristics for each HLA-DR group. The recipients in the D(-)R(+) pairing for HLA-DR13 and those in the D(+)R(-) pairing for HLA-DR15 had significantly higher rates of receiving treatment for rejection within the first year after transplant (P = 0.024 and P = 0.001, respectively). There were no differences in 5-y survival or freedom from BOS for any of the four HLA-DR alleles studied.
  
  
  
  There are higher rates of patients treated for rejection within the first year who are either negative for the HLA-DR15 allele but received a donor-positive lung or positive for the HLA-DR13 allele but received a donor-negative lung for that allele. However, these differences do not appear to affect long-term outcomes.
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Adam S A
authors.initials: AS
authors.lastname: Gracon
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Tiffany W
authors.initials: TW
authors.lastname: Liang
authors.affiliation: Department of Medicine, Division of Pulmonary and Critical Care, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Katia
authors.initials: K
authors.lastname: Rothhaar
authors.affiliation: Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Jingwei
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Medicine, Division of Pulmonary and Critical Care, Indiana University School of Medicine, Indianapolis, Indiana. Electronic address: dsw4n@virginia.edu.
authors.forename: David S
authors.initials: DS
authors.lastname: Wilkes
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D001989:Bronchiolitis Obliterans / Q000209:etiology / Q000276:immunology*; D005260:Female; D006084:Graft Rejection / Q000276:immunology*; D059810:HLA-DR Serological Subtypes / Q000378:metabolism*; D006801:Humans; D016015:Logistic Models; D016040:Lung Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000276:immunology*; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; D059810:HLA-DR Serological Subtypes; C097337:HLA-DR13 antigen; C106559:HLA-DR15 antigen
keywords: Antigen; Bronchiolitis obliterans syndrome; HLA-DR; Lung transplantation; Rejection; Type V collagen