HLA antibodies in pediatric heart transplantation

被引:19
作者
Ho, Eric K. [1 ]
Vasilescu, Elena R. [1 ]
Vlad, George [1 ]
Marboe, Charles C. [1 ]
Addonizio, Linda J. [2 ]
Suciu-Foca, Nicole [1 ]
机构
[1] Columbia Univ, Dept Pathol & Cell Biol, New York, NY 10032 USA
[2] Columbia Univ, Dept Pediat, New York, NY 10032 USA
关键词
pediatric heart transplant; anti-HLA antibodies; solid-phase assays; complement-mediated cytotoxicity; antibody-mediated rejection; post-transplant monitoring of antibodies; CORONARY-ARTERY-DISEASE; CARDIAC TRANSPLANTATION; MEDIATED REJECTION; CELLULAR REJECTION; HUMORAL REJECTION; ASSIST DEVICE; RISK-FACTORS; RECIPIENTS; CHILDREN; ACCOMMODATION;
D O I
10.1111/j.1399-3046.2010.01435.x
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
We have analyzed the impact of anti-HLA antibodies present in the patients' circulation prior and/or following heart transplantation in a population of 108 pediatric recipients. Anti-HLA class I and class II antibodies were monitored by traditional CDC using donor and panel T and B lymphocytes and by SPA for detection of DSA. There was a highly significant correlation between the development of AMR and presence of CDC- or SPA-detected DSA. However, the fraction of the transplant population which remained AMR-free was much higher among patients with SPA-detected compared to CDC-detected DSA. Furthermore, long-term graft survival was negatively affected only by cytotoxic, complement-fixing anti-HLA class I antibodies developing following transplantation. Anti-HLA class I or class II antibodies detected by SPA had no effect on long-term survival rates.
引用
收藏
页码:458 / 464
页数:7
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