Single-nucleotide polymorphisms in the β-adrenergic receptor genes are associated with lung allograft utilization

BACKGROUND: Pulmonary edema and associated impaired oxygenation are a major reason for rejection of donor lung allografts offered for transplantation. Clearance of pulmonary edema can be upregulated by stimulation of beta-adrenergic receptors (beta ARs). Single-nucleotide polymorphisms (SNPs) in beta AR genes have functional effects in vitro and in vivo. We hypothesized that SNPs in beta AR genes would be associated with rates of utilization of donor lung allografts offered for transplantation. METHODS: Nine hundred fifty-one organ donors were genotyped for 4 amino-acid-coding SNPs in the beta AR genes. Lung allograft utilization was compared among donors stratified by genotypes. RESULTS: Utilization of donor lung allografts was 55% vs 35% (p = 0.02) among donors with GG vs AA/AG genotypes of the Ser49Gly SNP, 39% vs 32% (p = 0.04) with GG vs AA/AG genotype of Gly16Arg SNP and 37% vs 32% (p = 0.1) with CC vs GC/GG genotype of the Arg389Gly SNP. In the combined analysis, donors carrying 0 or I associated genotype had a utilization rate of 33%, whereas donors carrying 2 or 3 associated genotypes had utilization rates of 44% and 58%, respectively (p = 0.008). There was a stepwise decrease in chest radiograph infiltrates and an increase in partial pressure of oxygen/fraction of inspired oxygen (PaO2/FIO2) with an increasing number of these associated genotypes. CONCLUSION: Genetic variants in the beta AR genes among organ donors are associated with higher rates of lung allograft utilization. The increased utilization may be related to increased clearance of pulmonary edema and improved oxygenation in donors with favorable genotypes and suggests that beta AR agonists may have a role in donor management. J Heart Lung Transplant 2011;30:211-7 (C) 2011 International Society for Heart and Lung Transplantation. All rights reserved.