INTRODUCTION: Recent studies suggested potential positive correlations between HLA-specific antibodies and development of cardiac allograft vasculopathy (CAV). METHODS: This prospective two-center study investigated early progression of CAV by coronary optical coherence tomography in 1 month and 12 months after heart transplantation (HTx) in 104 patients. Detection and characterization of donor specific (DSA) and MHC class-I polypeptide-related sequence A (MICA) antibodies were performed before, 1, 6 and 12 months after transplantation. RESULTS: During the first post-HTx year, we observed a significant reduction in the mean coronary luminal area (P < .001), and progression in mean intimal thickness (IT) (P < .001). DSA and anti-MICA occurred in 17% of all patients, but no significant relationship was observed between presence of DSA/anti-MICA and IT progression within 12 months after HTx. In contrast, we observed significant association between presence of DSA (p=0.031), de-novo DSA (p=0.031), HLA Class II DSA (p=0.017) and media thickness (MT) progression. CONCLUSION: Results of our study did not identify a direct association between presence of DSA/anti-MICA and intimal thickness progression in an early period after HTx. However, we found significant relationships between DSA and media thickness progression that may identify a newly recognized immune-pathological aspect of CAV.

2nd Department of Internal Medicine Department of Cardiovascular Medicine 1st Faculty of Medicine Charles University Prague and General University Hospital Prague Prague Czech Republic

Cardiovascular and Transplantation Surgery Brno Czech Republic

Center for Cardiovascular Prevention of the 1st Faculty of Medicine Charles University and Thomayer Hospital Prague Czech Republic

Department of Cardiology IKEM Prague Czech Republic

Department of Cardiology IKEM Prague Czech Republic; Department of Cardiology 2nd Medical School Charles University University Hospital Motol Prague Czech Republic

Department of Cardiovascular Diseases St Anne's University Hospital and Masaryk University Brno Czech Republic

Department of Immunogenetics Institute for Clinical and Experimental Medicine Prague Czech Republic

Iowa Institute for Biomedical Imaging The University of Iowa Iowa City IA USA

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