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Occurrence of Fatal and Nonfatal Adverse Outcomes after Heart Transplantation in Patients with Pretransplant Noncytotoxic HLA Antibodies
Joint Authors
Grigioni, Francesco
Barberini, Francesco
Fallani, Francesco
Bontadini, Andrea
Borgese, Laura
Manfredini, Valentina
Fruet, Fiorenza
Branzi, Angelo
Magnani, Gaia
Iannelli, Sandra
Leone, Ornella
Potena, Luciano
Masetti, Marco
Source
Issue
Vol. 2013, Issue 2013 (31 Dec. 2013), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2013-07-29
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
HLA antibodies (HLA ab) in transplant candidates have been associated with poor outcome.
However, clinical relevance of noncytotoxic antibodies after heart transplant (HT) is controversial.
By using a Luminex-based HLA screening, we retested pretransplant sera from HT recipients testing negative for cytotoxic HLA ab and for prospective crossmatch.
Out of the 173 consecutive patients assayed (52±13y; 16% females; 47% ischemic etiology), 32 (18%) showed pretransplant HLA ab, and 12 (7%) tested positive against both class I and class II HLA.
Recipients with any HLA ab had poorer survival than those without (65±9 versus 82±3%; P=0.02), accounting for a doubled independent mortality risk (P=0.04).
In addition, HLA-ab detection was associated with increased prevalence of early graft failure (35 versus 15%; P=0.05) and late cellular rejection (29 versus 11%; P=0.03).
Of the subgroup of 37 patients suspected for antibody mediated rejection (AMR), the 9 with pretransplant HLA ab were more likely to display pathological AMR grade 2 (P=0.04).
By an inexpensive, luminex-based, HLA-screening assay, we were able to detect non-cytotoxic HLA ab predicting fatal and nonfatal adverse outcomes after heart transplant.
Allocation strategies and desensitization protocols need to be developed and prospectively tested in these patients.
American Psychological Association (APA)
Potena, Luciano& Bontadini, Andrea& Iannelli, Sandra& Fruet, Fiorenza& Leone, Ornella& Barberini, Francesco…[et al.]. 2013. Occurrence of Fatal and Nonfatal Adverse Outcomes after Heart Transplantation in Patients with Pretransplant Noncytotoxic HLA Antibodies. Journal of Transplantation،Vol. 2013, no. 2013, pp.1-6.
https://search.emarefa.net/detail/BIM-478192
Modern Language Association (MLA)
Potena, Luciano…[et al.]. Occurrence of Fatal and Nonfatal Adverse Outcomes after Heart Transplantation in Patients with Pretransplant Noncytotoxic HLA Antibodies. Journal of Transplantation No. 2013 (2013), pp.1-6.
https://search.emarefa.net/detail/BIM-478192
American Medical Association (AMA)
Potena, Luciano& Bontadini, Andrea& Iannelli, Sandra& Fruet, Fiorenza& Leone, Ornella& Barberini, Francesco…[et al.]. Occurrence of Fatal and Nonfatal Adverse Outcomes after Heart Transplantation in Patients with Pretransplant Noncytotoxic HLA Antibodies. Journal of Transplantation. 2013. Vol. 2013, no. 2013, pp.1-6.
https://search.emarefa.net/detail/BIM-478192
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-478192