Session Time: 3:15pm-4:45pm
Presentation Time: 3:27pm-3:39pm
*Purpose: Multiple non-HLA antibodies have been implicated in poor outcomes after heart transplantation. Development of HLA and Non-HLA antibodies have been reported in association with ventricular assist device (VAD) implantation. However, most published studies have focused on one or limited number of non-HLA targets. In this study we simultaneously evaluated 48 non-HLA targets using a Luminex-based multiplex microarray (Immucor, Inc). Targets included cardiac and skeletal proteins, cytokines, and adhesion molecules.
*Methods: We tested paired pre- and post-implantation samples from 89 VAD recipients at our center (2010-2018). Sample pairs where the reaction to a given bead failed to meet quality metrics of the assay were excluded from the analysis for that target.
*Results: Patients were predominantly Caucasian (83%) men (84%). Mean age was 53 years (range 19-71). The majority of patients received a HeartMate II VAD (84%). In 75 patients (84%) we detected at least 2-fold increase in antibody level to one or more targets post-VAD compared to pre-VAD (mean 10.6, range 1-47 targets/patient). In 62 of those patients, the 2-fold increase was observed for multiple targets. Antibodies to 29 targets were positive in >20% of patients (Myosin, HSPB1, Collagen V, GSTT1, KRT8, LG3, PRKCZ, APOA1, FAS, KRT18, Collagen I, IFNg, CXCL9, CXCL11, VIM, FN1, Actin, Collagen III, PECR, AT1R, TUBA1B, PLA2R1-extracellular, LMNA, Collagen II, ICAM1, VCL, Collagen VI, Tubulin, FLRT2). None of the 48 targets tested were negative or positive in all patients. The following table shows the fold increase in antibody levels for targets yielding the largest effects (>20-fold increase).
*Conclusions: Our data suggest that the majority of patients undergoing VAD implantation develop high levels of antibodies to multiple non-HLA targets, potentially related to an inflammatory state triggered by these devices. Further studies are warranted to investigate the impact of these antibodies on transplant outcomes in patients who receive VAD as a bridge to heart transplantation.
To cite this abstract in AMA style:Askar M, Bhakta D, Zafar H, Alam A, Pittmon L, Kang S, Klingman L, Felius J, Joseph SM, Wencker D, Meyer DM, Hall SA. Multiplicity of Non-HLA Targets for Antibodies Developed in Association with Ventricular Assist Device Implantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/multiplicity-of-non-hla-targets-for-antibodies-developed-in-association-with-ventricular-assist-device-implantation/. Accessed November 30, 2020.
« Back to 2020 American Transplant Congress