Date: Sunday, June 12, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Purpose: Cardiac allograft vasculopathy (CAV) is a significant complication after cardiac transplantation (CTX). The presence of donor specific antibodies (DSA) has been associated with an increased incidence of CAV in cardiac transplant (CTX) patients.
Methods: A retrospective analysis of prospectively collected data for all CTX recipients at a single center from 2008-2015 who had at least one angiogram and donor specific HLA-antibody (DSA) measured. Luminex single antigen bead assays were used to assess DSAs per protocol up to 6 months then yearly after transplant. CAV is defined as a ≥30% stenosis of any primary vessel.
Results: This study included 262 CTX recipients, 45 (17.2%) developed any DSA, 19 (7.25%) developed Class I DSA, and 38 (14.5%) developed Class II DSA. Patients were median age of 57.3 years, 79.4% male, and 91.2% Caucasian. Those who developed Class I DSA were younger (median age 52.3 v. 57.6 years, p=0.011) and have higher Class I PRA at transplant (10.0 versus 2.0, p=0.003). There was no difference in characteristics for those who did and did not develop Class II PRA. 14/45 patients (31%) with any DSA developed CAV compared to 31/217 (14.3%) without DSA. 6/19 patients (31.5%) with Class I DSA developed CAV while 39/243 (16.0%) of patients without Class I DSA developed CAV. The presence of any DSA was associated with CAV. Specifically Class I DSA was associated with a 4.69 times increased risk of developing CAV (p=0.011). The presence of any Class II DSA did not significantly increase the risk of developing CAV (HR= 1.93, p=0.38).
Time to development of CAV is represented in Figure 1. The 6 year incidence of CAV in patients with any DSA, Class I DSA, and Class II DSA are 41%, 50%, and 41% respectively.
Conclusion: Patients with Class I DSA are at a higher risk of developing CAV compared to patients without DSA.
CITATION INFORMATION: Vu A, Althouse A, Zeevi A, Teuteberg J, Shullo M. Impact of Donor Specific Antibodies on Cardiac Allograft Vasculopathy. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Vu A, Althouse A, Zeevi A, Teuteberg J, Shullo M. Impact of Donor Specific Antibodies on Cardiac Allograft Vasculopathy. [abstract]. Am J Transplant. 2016; 16 (suppl 3). http://atcmeetingabstracts.com/abstract/impact-of-donor-specific-antibodies-on-cardiac-allograft-vasculopathy/. Accessed September 21, 2017.
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