PREDICTIVE SIGNIFICANCE OF ANTI-HLA AUTOANTIBODIES IN HEART TRANSPLANT RECIPIENTS

• Published in: Vestnik transplantologii i iskusstvennykh organov Vol. 15; no. 4; pp. 16 - 23
• Main Authors: O. P. Shevchenko, T. A. Khalilulin, G. A. Olefirenko, R. M. Kurabekova, N. V. Apanasenko, A. O. Shevchenko, B. L. Mironkov, I. M. Ilyinsky, A. G. Kupriyanova, A. J. Kormer
• Format: Journal Article
• Language: English
• Published: Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov 14-05-2014
• Subjects: heart transplantation, anti-hla antibodies, antibody-mediated rejection, cardiac allograft vasculopathy
• ISSN: 1995-1191
• DOI: 10.15825/1995-1191-2013-4-16-23

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.