Novel insights into pretransplant allosensitization in heart transplant recipients in the contemporary era of immunosuppression and rejection surveillance
Jazyk angličtina Země Švýcarsko Médium print-electronic
Typ dokumentu srovnávací studie, časopisecké články, práce podpořená grantem
PubMed
26340387
DOI
10.1111/tri.12684
Knihovny.cz E-zdroje
- Klíčová slova
- antibody-mediated rejection, heart transplantation, human leukocyte antigens antibodies, prognosis,
- MeSH
- analýza rozptylu MeSH
- dospělí MeSH
- HLA antigeny krev imunologie MeSH
- hodnocení rizik MeSH
- homologní transplantace škodlivé účinky metody MeSH
- imunizace metody MeSH
- imunologická tolerance fyziologie MeSH
- imunosupresivní léčba metody MeSH
- Kaplanův-Meierův odhad MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- následné studie MeSH
- prediktivní hodnota testů MeSH
- předoperační péče metody MeSH
- přežívání štěpu imunologie MeSH
- proporcionální rizikové modely MeSH
- rejekce štěpu imunologie MeSH
- retrospektivní studie MeSH
- ROC křivka MeSH
- rozdělení chí kvadrát MeSH
- specificita protilátek MeSH
- testování histokompatibility MeSH
- transplantace srdce škodlivé účinky metody mortalita MeSH
- transplantační imunologie fyziologie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Názvy látek
- HLA antigeny MeSH
Solid-phase assays (SPA) have facilitated detection and definition of antibodies to human leukocyte antigens (HLA) and major histocompatibility complex class I chain-related antigen A (MICA). However, clinical consequences of pretransplant SPA results in heart transplantation have been studied insufficiently in the current era of immunosuppression and rejection surveillance. Pretransplant sera, panel-reactive antibodies (PRA), pretransplant crossmatch, and clinical data were retrospectively analyzed in 264 adult heart transplant recipients. The specificity of HLA and MICA antibodies and C1q-binding activity of donor-specific antibodies (DSA) were defined using SPA. Pretransplant HLA antibodies were detected in 57 (22%) individuals, in 28 individuals (11%); these antibodies were DSA after transplant. Preformed DSA and elevated peak PRA were independent predictors of pathologic AMR, which occurred in 19 individuals (7%). The increasing number of DSA and the cumulative mean fluorescence intensity of DSA were associated with AMR. C1q-binding assay was a suboptimal predictor of AMR in our cohort. Pretransplant allosensitization and MICA antibodies were related neither to impaired graft survival nor to other adverse clinical events during a median follow-up of 39 months. Identification of preformed DSA by SPA, in addition to PRA monitoring, may predict AMR in the contemporary era of heart transplantation.
Department of Biostatistics Institute for Clinical and Experimental Medicine Prague Czech Republic
Department of Cardiac Surgery Institute for Clinical and Experimental Medicine Prague Czech Republic
Department of Cardiology Institute for Clinical and Experimental Medicine Prague Czech Republic
Department of Immunogenetics Institute for Clinical and Experimental Medicine Prague Czech Republic
Department of Pathology Institute for Clinical and Experimental Medicine Prague Czech Republic
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