Alloantibodies in heart transplantation

被引：57

作者：

Ho, Eric K. ^{[1
]}

Vlad, George ^{[1
]}

Colovai, Adriana I. ^{[1
]}

Vasilescu, E. Rodica ^{[1
]}

Schwartz, Joseph ^{[1
]}

Sondermeijer, Hugo ^{[1
]}

Burke, Elizabeth ^{[2
]}

Marboe, Charles C. ^{[1
]}

Itescu, Silviu ^{[2
]}

Suciu-Foca, Nicole ^{[1
]}

Mancini, Donna ^{[2
]}

机构：

[1] Columbia Univ, Dept Pathol, New York, NY 10027 USA

[2] Columbia Univ, Dept Med, New York, NY USA

来源：

HUMAN IMMUNOLOGY | 2009年 / 70卷 / 10期

关键词：

Heart transplantation; Anti-HLA antibodies; Allosensitization; Graft survival; ANTI-HLA ANTIBODIES; T-SUPPRESSOR-CELLS; CELLULAR REJECTION; CARDIAC TRANSPLANTATION; INDIRECT RECOGNITION; MEDIATED REJECTION; RISK-FACTORS; CROSS-MATCH; RECIPIENTS; COMPLEMENT;

D O I：

10.1016/j.humimm.2009.06.015

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

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 If 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 I 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. (C) 2009 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.

引用

页码：825 / 829

页数：5

共 36 条

[1] Complement in transplant rejection: diagnostic and mechanistic considerations [J].