M. Mirelli et al., Immune response following fresh arterial homograft replacement for aortoiliac graft infection, EUR J VAS E, 18(5), 1999, pp. 424-429
Citations number
43
Categorie Soggetti
Surgery
Journal title
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Introduction: this prospective study defines the immune response to fresh a
rterial homograft replacement for graft infection.
Materials and methods: ten patients who underwent ABO-compatible homograft
transplantation were studied for anti-HLA antibody production, and CD3-CD4-
CD8-positive lymphocytes subset. Immunological studies were performed preop
eratively, and at early (1, 3, 7 days) and late (1, 3, 6, 12, 18, 24 months
) follow-up. All patients received immunosuppressive treatment with cyclosp
orine (1-3 mg/kg/day). Abdominal CT scans were performed postoperatively at
the 1, 6, 12, 18, 24 months follow-up.
Results: preoperatively antibodies could not be detected. Postoperatively,
as from Ist month post-transplant, a progressive increase in % PRA was obse
rved in ail patients, tip to the 12th month of follow-up. Subsequently, at
18 nod 36 months, a progressive decrease in % PRA teas detected. Data showe
d that the recipient antibodies were directed against donor-specific antige
ns. During the immediate postoperative period (1, 3, 7 days) CD3- and CD4-p
ositive T lymphocytes slightly increased, whereas CD8 simultaneously decrea
sed. Later, CD3 and CD4 progressively decreased and CD8 increased. Clinical
ly all patients were cured of infection at late follow-up. CT scans showed
thickening of the aortic wall (range: 2.5-4.5 mm), with no signs of aneurys
mal degeneration.
Conclusions: fresh arterial homographs ape immunogenic. Implanted homograft
s induce a strong anti-HLA antibody response, similar to chronic rejection,
in spite of immunosuppressive treatment.