The observations were not found to be statistically significant based on the results of the Fisher exact test (= .67). Patient Outcomes Are Independent of Donor HLA Sensitization Status To determine the pattern between postoperative graft resorption and patient-reported outcomes, delta WOSI scores were compared between patients with each degree of graft resorption. postoperatively, donor HLA typing was used to confirm donor-specific sensitization. Pre- and postoperative computerized tomography scans (0.9 0.8 years follow-up) were used to grade resorption based on the modified Zhu resorption grade classification (ie, grade 0 = no resorption; grade 1 = less than 25% resorption; grade 2 = between 25% and 50% resorption; and grade 3 = larger than 50% resorption). The Western Ontario Shoulder Instability Index outcome scores were obtained preoperatively and at regular postoperative visits. Resorption and outcome data were compared between sensitized and nonsensitized patients using the Fisher exact test, independent PF-3635659 2-tailed Student = .67; = .05). Self-reported outcomes were not statistically significant between sensitized and nonsensitized patients (24.9 27.61 vs 40.16 18.99; = .37; = .05) and did not PF-3635659 differ significantly based on resorption grade (47.4 0.0 vs 55.2 18.8, 30.4 15.8 vs 39.9 20.9, 41.2 0.0 vs 39.1 13.1, and -24.9 0 vs 24.4 19.6 for resorption grades 0-3; .05; = .05). Conclusion: Sensitization against donor HLA after small bone graft allografting was not previously considered but has been brought to light as a possibility. Aside from potential complications for future organ transplants, HLA sensitization does not introduce a risk for adverse outcomes or higher grades PF-3635659 of resorption compared with nonsensitized patients after small bone allografting for shoulder instability. test to establish a trend between the degree of postoperative graft resorption and patient-reported outcomes. The change in pre- and postoperative WOSI scores (termed the delta WOSI score) was calculated for all patients if they had a baseline WOSI score and a postoperative WOSI score at least 6 months after surgery. The mean of these changes in WOSI scores was calculated for each resorption grade irrespective of HLA sensitization status and compared using unpaired ANOVA and paired 2-tailed Student test to compare overall changes in patient Rabbit polyclonal to ZBTB1 postoperative outcomes between sensitized and nonsensitized patients. Last, mean delta WOSI scores, with respect to both resorption grade and HLA sensitization status, were compared using a Wilcoxon rank-sum test (unpaired) due to the small number of patients in respective groups. This test was PF-3635659 used to determine if the change in patient outcome associated with a particular degree of resorption was significantly different between HLA sensitized and nonsensitized patients. Results Patient Groups and Exclusion From Analysis Initially, a total of 71 patients were included in the study (mean age, 28.85 years [range, 13.58-61.31 years]). A total of 13 patients from the original cohort were excluded from the analysis because of unavailable postoperative HLA antibody test results (n = 8), unavailable pre- and postoperative HLA antibody testing (n = 1), unavailable preoperative HLA antibody testing with no donor HLA typing for correlation (n = 3), and unavailable donor HLA typing for confirmation of a postoperative sensitization event in the context of preoperative HLA antibodies (n = 1). The remaining 58 patients with known sensitization status (7 sensitized and 51 nonsensitized patients) were evaluated for the frequency of postoperative HLA sensitization. The basic characteristics of the sensitized and nonsensitized populations are summarized in Table PF-3635659 1. Table 1 Characteristics of Sensitized and Nonsensitized Groups = .67). Open in a separate window Physique 3. Distribution in the frequency of resorption grades observed in 7 patients sensitized against donor human leukocyte antigen (HLA) and 32 nonsensitized patients. The observations were.