Lack of significant de novo HLA allosensitization in ventricular assist device recipients transfused with leukoreduced, ABO identical blood products

Ventricular assist devices provide support for a failing heart and often serve as a bridge to transplantation. The use of these devices has also been associated with allosensitization to HLA antigens because of transfusion of blood products. Our program established a protocol mandating the use of leukoreduced, irradiated and ABO identical products, including platelets, in patients receiving initial implantations of VADs as a bridge to transplantation. Recipients were tested for anti-HILA antibodies before VAD implantation and monthly post-implantation by cytotoxicity and solid phase assays. We observed minimal de novo anti-HLA sensitization (<10%) in this Population of 55 patients, each receiving a mean of 90 blood components, using this approach. No patient developed broad sensitization (PRA>50%). In conclusion, The use of leukoreduced, irradiated, ABO identical blood products abrogates broad allosensitization in this highly transfused Population. (C) 2009 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.