Development of Human Leukocyte Antigen (HLA) Antibodies Against Vascular Homograft Donor in Pediatric Heart Transplant Recipients

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Jahnukainen , T , Lauronen , J , Raissadati , A , Pihkala , J I , Ylinen , E , Puntila , J T , Salminen , J T , Pätilä , T , Mattila , I P & Jalanko , H J 2019 , ' Development of Human Leukocyte Antigen (HLA) Antibodies Against Vascular Homograft Donor in Pediatric Heart Transplant Recipients ' , Annals of transplantation , vol. 24 , pp. 454-460 . https://doi.org/10.12659/AOT.917232

Title: Development of Human Leukocyte Antigen (HLA) Antibodies Against Vascular Homograft Donor in Pediatric Heart Transplant Recipients
Author: Jahnukainen, Timo; Lauronen, Jouni; Raissadati, Alireza; Pihkala, Jaana I.; Ylinen, Elisa; Puntila, Juha Tapani; Salminen, Jukka T.; Pätilä, Tommi; Mattila, Ilkka P.; Jalanko, Hannu Jaakko
Contributor: University of Helsinki, HUS Children and Adolescents
University of Helsinki, HUS Children and Adolescents
University of Helsinki, HUS Children and Adolescents
University of Helsinki, HUS Children and Adolescents
University of Helsinki, HUS Children and Adolescents
University of Helsinki, HUS Children and Adolescents
University of Helsinki, Lastenkirurgian yksikkö
University of Helsinki, HUS Children and Adolescents
University of Helsinki, HUS Children and Adolescents
Date: 2019-08-06
Language: eng
Number of pages: 7
Belongs to series: Annals of transplantation
ISSN: 1425-9524
URI: http://hdl.handle.net/10138/306338
Abstract: Background: The appearance of human leukocyte antigen (HLA) antibodies after solid organ transplantation predisposes recipients to graft dysfunction. In theory, vascular homografts, which are widely used in children with congenital heart defects, may cause allosensitization. Material/Methods: In this single-center retrospective study, the presence of pre-existing HLA antibodies in pediatric heart trans- plant (HTx) recipients with a vascular homograft was evaluated in a cohort of 12 patients. HLA antibodies were screened before and after HTx and positive screening results were confirmed and identified using the Luminex (R) single antigen bead method. Endomyocardial biopsies (EMB) and coronary angiography studies were re-evaluated to assess the prevalence of acute rejections and coronary artery change in these patients. Results: At the time of HTx, 8 patients (67%) had HLA antibodies detected by the Luminex assay, none of which were heart donor specific (DSA). All patients had negative leukocyte crossmatch. One patient developed DSAs against homograft donor prior to HTx. After the HTx, 5 patients (42%) developed DSAs against the heart donor and 4 patients (40%) against the homograft donor. In 2 patients (17%), the antibodies were against both heart and homograft donors. The rejection rate or prevalence of coronary artery vasculopathy did not differ significantly between the homograft cohort and our historical controls. Conclusions: Our results suggest that the prevalence of DSAs against homograft donor prior to HTx is relatively rare. However, almost half of the patients developed DSAs against homograft post-HTx. The clinical importance of these antibodies warrants further studies.
Subject: Antibody Formation
Cadaver
Child
Heart Transplantation
HLA Antigens
Vascular Grafting
INTERNATIONAL SOCIETY
HEMODIALYSIS ACCESS
WORKING FORMULATION
ALLOGRAFT
IMPLANTATION
NOMENCLATURE
REJECTION
CHILDREN
IMPACT
VALVES
3126 Surgery, anesthesiology, intensive care, radiology
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