1. HLA Compatibility and Heart Transplant Survival Using A Validated Matching Algorithm
Andrew L. Rivard, MD, MS, Cleveland Clinic Abu Dhabi Naoru Koizumi, PhD, George Mason University

2. Relevant Financial Relationship Disclosure Statement
Human Leukocyte Compatibility and Heart Transplant Survival
Using A Validated Matching Algorithm
I will not discuss off label use and/or investigational use
No relevant financial relationships exist related to this presentation.

3. Outline Post heart transplant survival determinants
Donor / recipient tissue typing
UNOS – STARS file
HLA mismatching algorithm
Survival as based upon HLA mismatch
Future 3

4. UNET
Web Data Entry Form 4

5. Methods UNOS - STARS file 2003-2015 121,368 HTx recipients
209 US transplant centers
HLA mismatching algorithm
0-6 mismatches HLA-A, -B, -DR
>4 missing loci excluded 5

6. Methods UNOS - STARS file 2003-2015 121,368 HTx recipients
209 US transplant centers
HLA mismatching algorithm
0-6 mismatches HLA-A, -B, -DR
>4 missing loci excluded 6

7. Methods UNOS - STARS file 2003-2015 121,368 HTx recipients
209 US transplant centers
HLA mismatching algorithm
0-6 mismatches HLA-A, -B, -DR
>4 missing loci excluded 7

8. Methods UNOS - STARS file 2003-2015 121,368 HTx recipients
209 US transplant centers
HLA mismatching algorithm
0-6 mismatches HLA-A, -B, -DR
>4 missing loci excluded 8

9. Methods UNOS - STARS file 2003-2015 121,368 HTx recipients
209 US transplant centers
HLA mismatching algorithm
0-6 mismatches HLA-A, -B, -DR
>4 missing loci excluded 9

10. Methods UNOS - STARS file 2003-2015 121,368 HTx recipients
209 US transplant centers
HLA mismatching algorithm
0-6 mismatches HLA-A, -B, -DR
>4 missing loci excluded 10

11. Database
Relationship Design
Individual Table 11

12. HLA Table 12

13. HLA Table 13

14. Mismatch Algorithm Step 1 – Data validation Demonstrate data validity
Step 2 – Donor-Recipient mismatching
Logic (A ? X) comparison
Error handling
Demonstration of equivalency 14

15. Mismatch Algorithm Step 1 – Data validation Demonstrate data validity
Step 2 – Donor-Recipient mismatching
Logic (A ? X) comparison
Error handling
Demonstration of equivalency 15

16. User Interface 16

17. Results 21,878 HTx patients met criteria 398 patients (0-1 mismatch)
3 yr Survival ≤ 3 mismatch ≥ 4 mismatch (p=0.001)
Cox regression HLA-DR (p=0.003) 17

18. 18

19. 19

20. Survival Based Upon Mismatch20

21. 21

22. Conclusion Largest analysis of HLA data to date
UNOS independent mismatching algorithm
Survival ≤ 3 mismatch ≥ 4 mismatch
*HLA-DR
Thompson JS, Thacker Ii LR, Takemoto S. The influence of
conventional and cross-reactive group HLA matching on
cardiac transplant outcome: an analysis from the United
Network of Organ Sharing Scientific Registry. Transplantation
2000; 69: patients! 22

23. Thank you! 23