Alloantibodies in heart transplantation.

Abstract:

:The presence of complement fixing anti-human leukocyte antigen (HLA) antibodies in the circulation of organ transplant recipients may result in heart allograft rejection. Here, we assessed the clinical impact of pre- and post-transplantation allosensitization on long-term survival of heart allografts. Sequential samples of sera from heart allograft recipients were screened pretransplantation for panel reactive antibodies using the complement-dependent cytotoxicity test. Patients were monitored post-transplantation for donor specific anti-HLA class I and class II antibodies. Kaplan-Meier graft survival plots were generated to analyze the effect of anti-HLA antibodies on transplantation outcomes. Statistical analysis showed that the post-transplantation development of alloantibodies was a significant risk factor that was associated with low long-term survival rates; in contrast, recipients' gender, age, previous transplantations, and degree of HLA matching with the donor had no effect on long-term survival. The presence in pretransplantation sera of antibodies against more than 10% of the HLA reference panel (PRA >10%) was associated with AMR and with a relatively lower rate of graft survival after 1 year but did not affect 10-year survival. The present data underline the importance of monitoring the development of anti-HLA antibodies as a tool for early diagnosis and treatment of AMR.

journal_name

Hum Immunol

journal_title

Human immunology

authors

Ho EK,Vlad G,Colovai AI,Vasilescu ER,Schwartz J,Sondermeijer H,Burke E,Marboe CC,Itescu S,Suciu-Foca N,Mancini D

doi

10.1016/j.humimm.2009.06.015

subject

Has Abstract

pub_date

2009-10-01 00:00:00

pages

825-9

issue

10

eissn

0198-8859

issn

1879-1166

pii

S0198-8859(09)00161-X

journal_volume

70

pub_type

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