A Retrospective Review - Anti-HLA Antibodies

It is generally thought that immunologic mismatching in solid organ transplant will lead to increased rates of graft failure due to acute rejection in the short term and chronic rejection, or coronary vasculopathy in the longterm. Many studies in renal, pancreas and lung transplantation suggest favorable outcomes when HLA matching occurs and unfavorable outcomes when HLA mismatching occurs and circulating donor-specific antibodies are produced. However, in heart transplantation this association is less clear. Advances in recognition and identification of HLA antibodies have resulted in more specific information regarding HLA mismatching and outcomes. This study is aimed at analyzing outcomes in pediatric heart transplant based on recipient-donor HLA incompatibility and the post-transplant production of donor-specific HLA antibodies. Hypothesis: 1. HLA systems' genes class I \& II matching results in a survival/rejection benefit in pediatric heart transplant recipients. 2. Mismatched transplants with donor-specific HLA antibodies have decreased overall survival. A Multivariate Analysis of data will be performed by both Emory and Children's investigators and research support staff.