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Development of Non-Human Leukocyte Antigen Antibodies in Cardiac Antibody-Mediated Rejection

S. B. See1, B. S. Mantell2, K. J. Clerkin3, B. Ray4, E. R. Vasilescu5, C. Marboe5, Y. Naka6, S. Restaino1, P. C. Colombo3, L. J. Addonizio2, M. A. Farr3, E. Zorn1

1Columbia Center for Translational Immunology, Columbia University, New York, NY, 2Department of Pediatrics, Columbia University, New York, NY, 3Division of Cardiology, Columbia University, New York, NY, 4Immucor, Georgia, GA, 5Department of Pathology and Cell Biology, Columbia University, New York, NY, 6Department of Surgery, Columbia University, New York, NY

Meeting: 2019 American Transplant Congress

Abstract number: A44

Keywords: Antibodies, Autoimmunity, Heart, Rejection

Session Information

Session Name: Poster Session A: B-cell / Antibody /Autoimmunity

Session Type: Poster Session

Date: Saturday, June 1, 2019

Session Time: 5:30pm-7:30pm

 Presentation Time: 5:30pm-7:30pm

Location: Hall C & D

*Purpose: Antibody-mediated rejection (AMR), mainly driven by the development of donor-specific antibodies (DSA) directed against mismatched donor class I and class II HLA, is a major risk factor for graft loss in cardiac transplantation. In recent years, the relevance of non-HLA antibodies has become more prominent, particularly as antibody-mediated rejection can be diagnosed in the absence of DSA

*Methods: Here, we assessed a cohort of 64 orthotopic heart transplant recipients transplanted at NewYork-Presbyterian Hospital/Columbia University Medical Center between 1998 and 2014. Serum collected at the time of endomyocardial biopsy from 43 patients with AMR (≥pAMR1) and 21 control patients without AMR were tested for serum reactivity to a panel of 44 non-HLA autoantigens by Immucor.

*Results: The AMR group had a significantly greater percentage of patients with serum positivity (>MFI 1000) to panel autoantigens compared to AMR-negative controls (p=0.0009) and to a healthy control group of 94 non-transfused males (p<0.0001). Moreover, DSA-positive AMR patients exhibited greater reactivity to autoantigens compared to DSA-negative AMR patients (p=0.0098). This difference was driven by statistically significant increases in reactivity against 16 of the 44 autoantigens tested.

*Conclusions: These results suggest that antibodies to non-HLA are associated with DSA-positive AMR although their role in mediating allograft injury is not known. Furthermore, non-HLA autoantibodies do not appear to contribute to DSA-negative AMR.

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To cite this abstract in AMA style:

See SB, Mantell BS, Clerkin KJ, Ray B, Vasilescu ER, Marboe C, Naka Y, Restaino S, Colombo PC, Addonizio LJ, Farr MA, Zorn E. Development of Non-Human Leukocyte Antigen Antibodies in Cardiac Antibody-Mediated Rejection [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/development-of-non-human-leukocyte-antigen-antibodies-in-cardiac-antibody-mediated-rejection/. Accessed May 30, 2025.

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