Class I and class II anti-HLA antibodies after implantation of cryopreserved allograft material in pediatric patients

Citation
Ja. Hawkins et al., Class I and class II anti-HLA antibodies after implantation of cryopreserved allograft material in pediatric patients, J THOR SURG, 119(2), 2000, pp. 324-328
Citations number
28
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Journal title
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
ISSN journal
00225223 → ACNP
Volume
119
Issue
2
Year of publication
2000
Pages
324 - 328
Database
ISI
SICI code
0022-5223(200002)119:2<324:CIACIA>2.0.ZU;2-Q
Abstract
Objectives: Very little is known regarding the immune response to cryo-pres erved allograft valves and patch material used in the surgical repair of co ngenital heart defects. Methods: We prospectively measured the frequency of panel reactive antibodi es directed against HLA class I (HLA-A, B, and C) and class II (HLA-DR/DQ) alloantigens in 24 children receiving cryopreserved allografts. We compared them with results in II previously reported control patients. Sixteen of t he study patients underwent placement of a valved conduit (II. pulmonic, 5 aortic) between the right ventricle and pulmonary arteries, 6 underwent pat ch angioplasty of stenotic vessels with cryopreserved pulmonary artery and 2 underwent placement of a pulmonary monocusp patch. Study patients had pan el reactive antibodies measured before, 1 month, 3 months, and 1 year after the operation. Results: With allograft implantation, panel reactive antibodies increased f rom 1.9% +/- 5% before the operation to 62% +/- 33% at 31 +/- 8 days after the operation, 92% +/- 15% at 3.3 +/- 0.6 months after the operation, and 8 5% +/- 18% at 1.1 +/- 0.2 years after the operation. The control group show ed no change in panel reactive antibodies, with a level of 1.6% +/- 1% befo re the operation, 3.2% +/- 1% 28 +/- 5 days after the operation, and 1.7% /- 1% 2.7 +/- 0.3 months after the operation. Class II antibodies (anti-HLA -DR/DQ) rose to 49% +/- 35% at 30 +/- 8 days and 70% +/- 26% at 3.3 +/- 0.6 months after the operation, Conclusions: Cryopreserved allograft material induces a marked response tha t involves both class I and class II anti-HLA antibodies within 3 months af ter operation in children. This alloantibody response may represent a form of "rejection," may have implications for those who require subsequent card iac transplantation, and may play a role in early allograft failure.