Evaluation of humoral immune response to donor HLA after implantation of cellularized versus decellularized human heart valve allografts

• Published in: Tissue antigens Vol. 80; no. 2; pp. 165 - 174
• Main Authors: Kneib, C., von Glehn, C. Q. C., Costa, F. D. A., Costa, M. T. B. A., Susin, M. F.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-08-2012
• Subjects: Adult; Aged; anti-HLA antibody detection; Antibody Specificity; Aortic Valve - immunology; Aortic Valve - transplantation; decellularization process; Epitopes; Female; Histocompatibility Antigens Class I - immunology; Histocompatibility Antigens Class II - immunology; HLAMatchmaker; Humans; Immunity, Humoral; Isoantibodies - biosynthesis; Isoantibodies - immunology; Male; Middle Aged; Pulmonary Valve - immunology; Pulmonary Valve - transplantation; Tissue Donors; Transplantation, Homologous; valve transplant
• ISSN: 0001-2815; 1399-0039
• DOI: 10.1111/j.1399-0039.2012.01885.x

We have evaluated the development of antibodies in response to donor allograft valve implant in patients who received cellularized and decellularized allografts and determined possible immunogenic epitopes considered responsible for antibodies reactivity. Serum samples from all recipients who received cellularized allografts or decellularized allografts were collected before valve replacement and at 5, 10, 30 and 90 days post‐operatively and frozen until required. Tests were performed using the Luminex‐based single human leukocyte antigen (HLA)‐A, ‐B, ‐C and HLA‐DR, ‐DQ antigen microsphere assay. To determine possible immunogenic epitopes, we used the HLAMatchmaker (HLAMM) software if applicable. Decellularized grafts elicited lower levels of anti‐HLA class I and II antibody formation after implantation than cellularized allografts. All patients from cellularized group presented donor‐specific antibodies class I and II within 3 months of observation period. In HLAMM analysis, the cellularized group had significantly higher numbers of immunogenic epitopes than decellularized group for both class I and II (p: 0.002 – cl I / p: 0.009 – cl II / p: 0.004 – cl I and II). Our findings demonstrate that the anti‐HLA antibodies detected in the cellularized group were against donor HLA possible immunogenic epitopes and that in the decellularized group the anti‐HLA antibodies were not against donor HLA possible immunogenic epitopes. These findings lead us to suggest that choosing sodium dodecyl sulfate decellularization process is the best alternative to decrease the immunogenicity of allograft valve transplant.