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Meta-Analysis
. 2010 Jul 21;16(27):3457-64.
doi: 10.3748/wjg.v16.i27.3457.

Impact of human leukocyte antigen mismatching on outcomes of liver transplantation: a meta-analysis

Xiang Lan  1 , Ming-Man Zhang, Cong-Lun Pu, Chun-Bao Guo, Quan Kang, Ying-Chun Li, Xiao-Ke Dai, Yu-Hua Deng, Qiang Xiong, Zhi-Mei Ren
Affiliations
Meta-Analysis

Impact of human leukocyte antigen mismatching on outcomes of liver transplantation: a meta-analysis

Xiang Lan et al. World J Gastroenterol. .

Abstract

Aim: To assess the effect of human leukocyte antigen (HLA) mismatching on liver graft outcome and acute rejection from a meta-analysis of available cohort studies.

Methods: Articles in PubMed/MEDLINE, EMBASE and the Cochrane database from January 1970 to June 2009, including non-English literature identified in these databases, were searched. Only studies comparing HLA or sub-phenotype matching with mismatching were extracted. The percentage of graft survival was extracted by "Engauge Digitizer" from survival curves if the raw data were not displayed. A meta-analysis was performed when at least 3 studies provided data.

Results: Sixteen studies met the inclusion criteria. A lower number of HLA mismatches (0-2 vs 3-6) did reduce the incidence of acute rejection (relative risk: 0.77, P = 0.03). The degree of HLA mismatching (0-2 vs 3-6) had no significant effect on 1-year [hazard ratio (HR): 1.04, P = 0.68] and 5-year (HR: 1.09, P = 0.38) graft survival. In sub-phenotype analysis, the degree of HLA-A, B and DR mismatching (0 vs 1-2) had no significant effect on 1-year and 5-year graft survival, either. The HRs and P-values were 0.95, 0.71 (HLA-A, 1-year); 1.06, 0.60 (HLA-A, 5-year); 0.77, 0.16 (HLA-B, 1-year); 1.07, 0.56 (HLA-DR, 1-year); 1.18, 0.23 (HLA-DR, 5-year), respectively.

Conclusion: The results of this systematic review imply that good HLA compatibility can reduce the incidence of acute rejection in spite of having no influence on graft outcomes. To obtain a short recovery time and minimize rejection post transplantation, HLA matching studies should be considered before the operation.

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Figures

Figure 1
Figure 1
Selection of articles.
Figure 2
Figure 2
Meta-analysis of cohort trials comparing the effect of different mismatches of human leukocyte antigen epitopes on graft survival and acute rejection. A: 0-2 vs 3-6 mismatches of human leukocyte antigen (HLA)-A, B, DR epitopes on 1-year graft survival; B: 0-2 vs 3-6 mismatches of HLA-A, B, DR epitopes on 5-year graft survival; C: 0 vs 1-2 mismatches of HLA-A epitopes on 1-year graft survival; D: 0 vs 1-2 mismatches of HLA-A epitopes on 5-year graft survival; E: 0 vs 1-2 mismatches of HLA-B epitopes on 1-year graft survival; F: 0 vs 1-2 mismatches of HLA-DR epitopes on 1-year graft survival; G: 0 vs 1-2 mismatches of HLA-DR epitopes on 5-year graft survival; H: 0-2 vs 3-6 mismatches of HLA-A, B and DR epitopes on acute rejection.
See this image and copyright information in PMC

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