Background: HLA-DQ donor-specific antibodies (DSA) are implicated in allograft dysfunction after renal and lung transplantation. Limited data exists on the impact of HLA-DQ antibodies on heart transplant patients.
Objective: To investigate the impact of DSA formation on allograft function and outcomes in heart transplant patients.
Design: Retrospective cohort study.
Setting: Collating post-transplantation patient data from computerized database in a tertiary hospital in Riyadh, Saudi Arabia from January 2006 to October 2014.
Patients And Methods: We excluded recipients with positive preoperative complement-dependent-cytotoxicity crossmatch grafts and those with preformed DSA. Anti-HLA antibodies were identified using Luminex-based assay in sera collected before transplantation with a routine endomyocardial biopsy the first year and then annually.
Main Outcome Measures: Primary outcome measures were all-cause mortality, development of antibody mediated rejection, treated acute cellular rejection (ACR) and cardiac allograft vasculopathy (CAV).
Sample Size: 127 patients.
Results: DSA formation occurred in 43/127 (34%), with 33/43 (77%) targeting HLA-DQ antigens alone (n=7) or in combination with -DR, -A or B antibodies (n=26). Most (76%) were male and the mean (SD) age was 36 (14) years. Ten patients developed -A, -B or -DR antibodies without -DQ antibodies also present. Treated ACR (P=.011), reduced left ventricular ejection fraction (P less than .001), CAV development (P=.003), and all-cause mortality (P=.01) were all significantly more prevalent in the DSA-positive cohort.
Conclusion: HLA-DQ donor-specific antibodies were the most common type detected and may play a significant role in poor outcomes post-cardiac transplantation. This emphasizes the importance of HLA-DQ matching and monitoring for DSA formation in order to minimize post-transplantation immunological risk.
Limitations: Retrospective design comes with inherent biases, results from single institute, with a particularly young cohort.
Conflict Of Interest: None.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6074361 | PMC |
| http://dx.doi.org/10.5144/0256-4947.2018.97 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The pitfalls and challenges in the diagnosis and treatment of patients with carotid near-occlusion: a narrative review.
Quant Imaging Med Surg
December 2024
Department of Radiology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China.
Background And Objective: Carotid near-occlusion (CNO) is defined as a severe stenosis of the internal carotid artery (ICA) resulting in a reduction in the distal diameter. It is a specific type of carotid stenosis accounting for 34% of the patients with symptomatic carotid stenosis ≥50%. The current guidelines recommend the best medical treatment (BMT) as the treatment of choice.
View Article and Find Full Text PDFImproved Skin Barrier Function Along with Hydration Benefits of Extract, Aesculin, and Schaftoside and LC-HRMS/MS Dereplication of Its Bio-Active Components.
Int J Mol Sci
November 2024
L'Oréal Research and Innovation, Bangalore 560067, India.
The skin hydration level is a key factor that influences the physical and mechanical properties of the skin. The stratum corneum (SC), the outermost layer of the epidermis, is responsible for the skin's barrier function. In this study, we investigated the role of a unique composition of extract for its ability to activate CD44, a cell-surface receptor of hyaluronic acid, and aquaporin-3, a water-transporting protein, in human keratinocytes (HaCaT).
View Article and Find Full Text PDFThe clinical reality of "disappeared" lateral posterior choroidal artery aneurysm: case report.
Neurol Sci
December 2024
Department of Neurosurgery, The Second Clinical Medical College, Nanchong Central Hospital, North Sichuan Medical College, No. 97 Renmin South Road, Nanchong, Sichuan, 637000, China.
Spontaneous disappearance of aneurysms, undetectable by conventional angiography, has been reported. This case report presents a patient with ventricular hemorrhage secondary to a ruptured lateral posterior choroidal artery aneurysm, confirmed by digital subtraction angiography (DSA). Without any intervention, follow-up DSA 11 months later showed an apparent "disappearance" of the aneurysm.
View Article and Find Full Text PDFPhysician-Directed Mycophenolate Mofetil Dose Reduction After Kidney Transplantation: A Multicenter Real Word Experience.
Transplant Proc
December 2024
The William J. von Liebig Center for Transplantation and Clinical Regeneration, Rochester, Minnesota; Department of Surgery and Immunology, Mayo Clinic, Rochester, Minnesota.
Background: Mycophenolate mofetil (MMF) dose is commonly reduced after kidney transplantation (KT). This study examined MMF dosing in the first 5 years after KT to determine if a lower MMF dose impacted outcomes.
Methods: We retrospectively studied 432 recipients who underwent KT between February 2012 and February 2015 in 3 centers.
In situ evolved high-valence Co active sites enable highly efficient and stable chlorine evolution reaction.
J Colloid Interface Sci
December 2024
Chongqing Key Laboratory of Green Catalysis Materials and Technology, College of Chemistry, Chongqing Normal University, Chongqing 401331, China. Electronic address:
The chlor-alkali process is crucial in the modern chemical industry, yet it is highly energy-intensive, consuming about 4 % of global electricity due to the significant overpotential and low selectivity of existing chlorine evolution reaction (CER) electrocatalysts. Although advanced electrocatalysts have reduced the energy demands of the chlor-alkali process, they typically incorporate precious metals. Here, we introduce a novel precious metal-free electrocatalyst, (CoZn)VO@C, with a hollow nanocube structure that exhibits outstanding CER performance.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!