PREDICTIVE SIGNIFICANCE OF ANTI-HLA AUTOANTIBODIES IN HEART TRANSPLANT RECIPIENTS
https://doi.org/10.15825/1995-1191-2013-4-16-23
Abstract
Aim. The aim of this study was to define the role of preformed anti-HLA antibodies (anti-HLA) in antibody-mediated rejection (AMR) and cardiac allograft vasculopathy (CAV) after heart transplantation.
Materials and Methods. 140 heart transplant recipients were followed after heart transplantation performed for 106 dilated and 34 – ischemic cardiomyopathy. Anti-HLA was determined before transplantation by ELISA.
Results. Recipients were divided into 2 groups: anti-HLA positive (n = 45, 32,1%) and anti-HLA negative (n = 95, 67,9%). The incidence of AMR in anti-HLA positive group was 12 (26,67%) and 11 (11,58%) in anti-HLA negative group. Risk of AMR was significantly higher in anti-HLA positive recipients (RR 2,3: 95% CI 1,02–4,81, р = 0,03). During first three years after transplantation CAV was diagnosed in 9 (20%) of anti-HLA positive recipients and in 7 (6,8%) of patients without anti-HLA. (RR 2,7: 95% CI 1,08–6,82, р = 0,03). Survival in freedom from CAV in anti-HLA negative recipients was much higher than in anti-HLA positive recipients (0,89 ± 0,07, 0,72 ± 0,06, resp. (p = 0,02)).
Conclusions. The presence of preformed anti-HLA antibodies in candidates for heart transplantation increase the risk of AMR and CAV post transplantation in 2,3 and 2,7 times, respectively.
About the Authors
O. P. Shevchenko
Department of regulatory mechanisms in transplantology (Head – prof. O.P. Shevchenko) of Academician V.I. Shumakov federal research center of transplantology and artificial organs, Ministry
of Health of Russian Federation (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
T. A. Khalilulin
Department of cardiac surgery, heart and lung transplantation (Head – prof. R.Sh. Saitgareev) of Academician V.I. Shumakov federal research center of transplantology and artificial organs, Ministry
of Health of Russian Federation (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
Chair of transplantology and artificial organs (Head – academician of RAMSci, prof. S.V. Gautier)
I.M. Sechenov First Moscow State Medical University (Rector – corresponding member of RAMSci, prof. P.V. Glybochko), Moscow, Russian Federation
G. A. Olefirenko
Department of regulatory mechanisms in transplantology (Head – prof. O.P. Shevchenko) of Academician V.I. Shumakov federal research center of transplantology and artificial organs, Ministry
of Health of Russian Federation (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
R. M. Kurabekova
Department of regulatory mechanisms in transplantology (Head – prof. O.P. Shevchenko) of Academician V.I. Shumakov federal research center of transplantology and artificial organs, Ministry
of Health of Russian Federation (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
N. V. Apanasenko
Department of regulatory mechanisms in transplantology (Head – prof. O.P. Shevchenko) of Academician V.I. Shumakov federal research center of transplantology and artificial organs, Ministry
of Health of Russian Federation (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
A. O. Shevchenko
Department of coordination and monitoring of research programs of Academician V.I. Shumakov federal research center of transplantology and artificial organs, Ministry of Health of Russian Federation (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
Pirogov Russian National Research Medical University. Faculty of advanced medical studies (Rector – prof. A.G. Kamkin), Moscow, Russian Federation
B. L. Mironkov
Department of cardiac surgery, heart and lung transplantation (Head – prof. R.Sh. Saitgareev) of Academician V.I. Shumakov federal research center of transplantology and artificial organs, Ministry
of Health of Russian Federation (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
I. M. Ilyinsky
Chair of transplantology and artificial organs (Head – academician of RAMSci, prof. S.V. Gautier)
I.M. Sechenov First Moscow State Medical University (Rector – corresponding member of RAMSci, prof. P.V. Glybochko), Moscow, Russian Federation
Department of clinical pathology (Head – prof. I.M. Ilyinsky) of Academician V.I. Shumakov federal research center of transplantology and artificial organs, Ministry of Health of Russian Federation (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
A. G. Kupriyanova
Chair of transplantology and artificial organs (Head – academician of RAMSci, prof. S.V. Gautier)
I.M. Sechenov First Moscow State Medical University (Rector – corresponding member of RAMSci, prof. P.V. Glybochko), Moscow, Russian Federation
Laboratory of immunohistochemistry (Head – cand. of med. sci. A.G. Kupriyanova, department of clinical pathology (Head – prof. I.M. Ilyinsky) of Academician V.I. Shumakov federal research center of transplantology and artificial organs, Ministry of Health of Russian Federation (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
A. J. Kormer
Department of cardiac surgery, heart and lung transplantation (Head – prof. R.Sh. Saitgareev) of Academician V.I. Shumakov federal research center of transplantology and artificial organs, Ministry
of Health of Russian Federation (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
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Review
For citations:
Shevchenko O.P., Khalilulin T.A., Olefirenko G.A., Kurabekova R.M., Apanasenko N.V., Shevchenko A.O., Mironkov B.L., Ilyinsky I.M., Kupriyanova A.G., Kormer A.J. PREDICTIVE SIGNIFICANCE OF ANTI-HLA AUTOANTIBODIES IN HEART TRANSPLANT RECIPIENTS. Russian Journal of Transplantology and Artificial Organs. 2013;15(4):16-23. (In Russ.) https://doi.org/10.15825/1995-1191-2013-4-16-23
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