Date: Tuesday, May 5, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Purpose: The development of donor-specific antibodies (DSA) after heart transplant has been correlated to the subsequent development of graft rejection. The development of DSA are divided into class I and class II anti-Human Leukocyte Antigen antibodies. It is not clear as to whether each class may have a different impact on the development of acute and chronic rejection.
Methods: Between 2010 and 2013 we assessed 58 patients who developed DSA in the first year after heart transplant. We divided these patients into those who had class I only, class II only, and combined class I and II DSA. Patients were followed for 1 year after the development of antibodies to determine its effect on rejection.
Results: Patients with class II DSA appear to have a numerically lower freedom from any-treated rejection and treated antibody-mediated rejection compared to patients with class I only. Patients who developed both class I and class II DSA were seen to have the lowest freedom from any-treated rejection and treated antibody-mediated rejection (see table). There was no difference among groups in subsequent 1-year survival or freedom from CAV.
|Class I DSA (n=13)||Class II DSA (n=31)||Class I + II DSA (n=14)||Log-Rank P-Value|
|Subsequent 1-Year Survival||100.0%||93.5%||100.0%||0.413|
|Subsequent 1-Year Freedom from Any-Treated Rejection||100.0%||78.8%||55.1%||0.026|
|Subsequent 1-Year Freedom from Acute Cellular Rejection||100.0%||79.2%||69.8%||0.155|
|Subsequent 1-Year Freedom from Antibody-Mediated Rejection||100.0%||93.5%||71.4%||0.028|
|Subsequent 1-Year Freedom from Biopsy Negative Rejection||100.0%||96.8%||100.0%||0.647|
|Subsequent 1-Year Freedom from CAV||100.0%||95.0%||92.9%||0.840|
Conclusion: Having both class I and II DSAs appear to have the lowest freedom from the development of treated rejections after heart transplant. More aggressive immunosuppression therapy may be required for patients who develop both classes of antibody. Larger studies with longer follow-up are needed to confirm these findings.
To cite this abstract in AMA style:Liou F, Kittleson M, Patel J, Siddiqui S, Luu M, Kearney B, Ramzy D, Chang D, Czer L, Reinsmoen N, Kobashigawa J. Effects of Anti-Human Leukocyte Antigen Antibody After Heart Transplantation [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/effects-of-anti-human-leukocyte-antigen-antibody-after-heart-transplantation/. Accessed July 30, 2021.
« Back to 2015 American Transplant Congress