title: Acute cellular rejection and HLA mismatch in heart transplantation: insights from a developing country.
abstract: The notable evolution of heart transplant (HTX) has paralleled the capacity of diagnosing rejection and, consequently, initiating timely treatment. Acute cellular rejection, diagnosed by endomyocardial biopsy, is the most frequent in the first 6 months after HTX. HLA matching is not routinely performed in HTX due to the absence of consensus regarding its usefulness. However, the use of HLA typing might be underscored if it could predict an increased risk of rejection. Therefore, the aim of this study was to evaluate, at a public cardiology center in Brazil, the association between HLA mismatches and the incidence of acute cellular rejection in the first 6 months after HTX. Data were obtained from hospital records and from the National Transplant System. Overall, there was no association between the number of HLA mismatches and the frequency of acute cellular rejection, but there was a tendency toward a higher incidence of rejection with HLA-DR incompatibility.
authors.affiliation: Instituto Nacional de Cardiologia, Rio de Janeiro, RJ, Brazil. lschtruk@ig.com.br.
authors.forename: Lígia Beatriz Chaves Espinoso
authors.initials: LB
authors.lastname: Schtruk
authors.affiliation: Instituto Nacional de Cardiologia, Rio de Janeiro, RJ, Brazil.
authors.forename: Tereza Cristina Fellipe
authors.initials: TC
authors.lastname: Guimarães
authors.affiliation: Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Luis Cristóvão
authors.initials: LC
authors.lastname: Pôrto
authors.affiliation: Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Maria Cristina Caetano
authors.initials: MC
authors.lastname: Kuschnir
authors.affiliation: Instituto Nacional de Cardiologia, Rio de Janeiro, RJ, Brazil.
authors.forename: Alexandre Siciliano
authors.initials: AS
authors.lastname: Colafranceschi
authors.affiliation: Instituto Nacional de Cardiologia, Rio de Janeiro, RJ, Brazil.
authors.forename: Paulo Moreira da Silva
authors.initials: PM
authors.lastname: Filho
authors.affiliation: Instituto Nacional de Cardiologia, Rio de Janeiro, RJ, Brazil.
authors.forename: Andrea
authors.initials: A
authors.lastname: De Lorenzo
mesh_terms: D000208:Acute Disease; D001706:Biopsy; D001938:Brazil / Q000453:epidemiology; D003906:Developing Countries; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology*; D006085:Graft Survival; D016027:Heart Transplantation / Q000009:adverse effects*; D006648:Histocompatibility / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: HLA; HLA incompatibility; cardiac transplantation; rejection