Anti-HLA antibodies in heart transplantation

We have analyzed the relationship between the development of transplant-related coronary artery disease (TRCAD) and the following potential risk factors: (a) number of HLA mismatches between recipient and donor; (b) production of anti-HLA antibodies; (c) growth of lymphocytes infiltrating the graft; and (d) frequency of biopsy proven episodes of acute rejection. The study population consisted of 285 adult heart allograft recipients who were monitored over a period of two years or more. The results demonstrate a significant correlation between TRCAD, generation of anti-HLA class II antibodies and potential of lymphocytes infiltrating the graft to proliferate ex-vivo in medium containing IL-2. Humoral and cellular immune responses to HLA-DR antigens expressed by the graft seem to underlie the development of TRCAD. (C) 2003 Elsevier B.V. All rights reserved.