Your browser doesn't support javascript.
loading
Prospective examination of HLA sensitization after VAD implantation in children and adults.
Townsend, Madeleine; Pidborochynski, Tara; Cantor, Ryan S; Khoury, Michael; Campbell, Patricia; Halpin, Anne; Urschel, Simon; Kim, Daniel; Nahirniak, Susan; West, Lori J; Buchholz, Holger; Conway, Jennifer.
Afiliación
  • Townsend M; Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada. Electronic address: townsem6@ccf.org.
  • Pidborochynski T; Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada.
  • Cantor RS; Kirklin Solutions, Birmingham, AL, United States of America.
  • Khoury M; Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute, University of Alberta, Edmonton, AB, Canada; Canada Donation And Transplantation Research Program, University of Alberta, Ed
  • Campbell P; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute, University of Alberta, Edmonton, AB, Canada; Department of Medicine, University of Alberta, Edmonton, AB, Canada.
  • Halpin A; Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute, University of Alberta, Edmonton, AB, Canada; Department of Medicine, University of Alberta, Edmonton, AB,
  • Urschel S; Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute, University of Alberta, Edmonton, AB, Canada; Canada Donation And Transplantation Research Program, University of Alberta, Ed
  • Kim D; Alberta Transplant Institute, University of Alberta, Edmonton, AB, Canada; Department of Medicine, University of Alberta, Edmonton, AB, Canada; Department of Surgery, University of Alberta, Edmonton, AB, Canada.
  • Nahirniak S; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada.
  • West LJ; Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute, University of Alberta, Edmonto
  • Buchholz H; Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Department of Medicine, University of Alberta, Edmonton, AB, Canada; Mazankowski Alberta Heart Institute, Edmonton, AB, Canada.
  • Conway J; Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute, University of Alberta, Edmonton, AB, Canada.
Transpl Immunol ; 80: 101892, 2023 Oct.
Article en En | MEDLINE | ID: mdl-37419373
BACKGROUND: Ventricular assist devices (VADs) have improved survival to heart transplantation (HTx). However, VADs have been associated with development of antibodies against human leukocyte antigen (HLA-Ab) which may limit the donor pool and decrease survival post-HTx. Since HLA-Ab development after VAD insertion is poorly understood, the purpose of this prospective single-center study was to quantify the incidence of and evaluate risk factors for HLA-Ab development across the age spectrum following VAD implantation. METHODS: Adult and pediatric patients undergoing VAD placement as bridge to transplant or transplant candidacy between 5/2016 and 7/2020 were enrolled. HLA-Ab were assessed pre-VAD and at 1-, 3-, and 12-months post-implant. Factors associated with HLA-Ab development post-VAD implant were explored using univariate and multivariate logistic regression. RESULTS: 15/41 (37%) adults and 7/17 (41%) children developed new HLA-Ab post-VAD. The majority of patients (19/22) developed HLA-Ab within two months of implant. New class I HLA-Ab were more common (87% adult, 86% pediatric). Prior pregnancy was strongly associated with HLA-Ab development in adults post-VAD (HR 16.7, 95% CI 1.8-158, p = 0.01). Of the patients who developed new HLA-Ab post-VAD, in 45% (10/22) the HLA-Ab resolved while in 55% (12/22) the HLA-Ab persisted. CONCLUSION: More than one-third of adult and pediatric VAD patients developed new HLA-Ab early after VAD implant with the majority having class I antibodies. Prior pregnancy was strongly associated with post-VAD HLA-Ab development. Further studies are needed to predict regression or persistence of HLA-Ab developed post-VAD, to understand modulation of individuals' immune responses to sensitizing events, and to determine whether transiently detected HLA-Ab post-VAD recur and have long-term clinical impact post-heart transplantation.
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Transpl Immunol Asunto de la revista: ALERGIA E IMUNOLOGIA / TRANSPLANTE Año: 2023 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies / Risk_factors_studies Idioma: En Revista: Transpl Immunol Asunto de la revista: ALERGIA E IMUNOLOGIA / TRANSPLANTE Año: 2023 Tipo del documento: Article Pais de publicación: Países Bajos