Donor specific anti-HLA antibodies and cardiac allograft vasculopathy: A prospective study using highly automated 3-D optical coherence tomography analysis

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PAZDERNIK Michal BEDANOVA Helena CHEN Zhi KAUTZNER Josef MELENOVSKY Vojtech MALEK Ivan SLAVCEV Antonij BARTONOVA Michaela KARMAZIN Vladimir ECKHARDT Tomas TOMASEK Ales OZÁBALOVÁ Eva KOVARNIK Tomas WOHLFAHRT Peter SONKA Milan

Rok publikování 2021
Druh Článek v odborném periodiku
Časopis / Zdroj Transplant Immunology
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
www https://www.sciencedirect.com/science/article/pii/S0966327420301489?via%3Dihub
Doi http://dx.doi.org/10.1016/j.trim.2020.101340
Klíčová slova Cardiac allograft vasculopathy; Donor specific antibodies; Heart transplant; Intimal thickness
Popis Introduction: Recent studies suggested potential positive correlations between HLA-specific antibodies and development of cardiac allograft vasculopathy (CAV). Methods: This prospective two-center study investigated early progression of CAV by coronary optical coherence tomography in 1 month and 12 months after heart transplantation (HTx) in 104 patients. Detection and characterization of donor specific (DSA) and MHC class-I polypeptide-related sequence A (MICA) antibodies were performed before, 1, 6 and 12 months after transplantation. Results: During the first post-HTx year, we observed a significant reduction in the mean coronary luminal area (P < .001), and progression in mean intimal thickness (IT) (P < .001). DSA and anti-MICA occurred in 17% of all patients, but no significant relationship was observed between presence of DSA/anti-MICA and IT progression within 12 months after HTx. In contrast, we observed significant association between presence of DSA (p=0.031), de-novo DSA (p=0.031), HLA Class II DSA (p=0.017) and media thickness (MT) progression. Conclusion: Results of our study did not identify a direct association between presence of DSA/anti-MICA and intimal thickness progression in an early period after HTx. However, we found significant relationships between DSA and media thickness progression that may identify a newly recognized immune-pathological aspect of CAV.

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