Changes in the methodology of pre-heart transplant human leukocyte antibody assessment: an analysis of the United Network for Organ Sharing database.
Clin Transplant
; 29(9): 842-50, 2015 Sep.
Article
em En
| MEDLINE
| ID: mdl-26172275
ABSTRACT
BACKGROUND:
We sought to investigate temporal trends in the methodology of human leukocyte antibody assessment in heart transplantation.METHODS:
The United Network for Organ Sharing database was queried from June 2004 to March 2013 to obtain pre-heart transplantation human leukocyte antibody results. The % panel reactive antibody for class I and II antibodies was recorded along with the methodology of assessment. Allosensitization was defined as class I and/or II panel reactive antibody of ≥ 10%. The primary outcome measure was graft survival.RESULTS:
During the study period, 12,858 patients with available data underwent heart transplantation. The prevalence of allosensitization increased, with 16.8% in 2005-2006 sensitized at the time of transplantation compared to 23.1% in 2010-2011 (p < 0.001); this occurred in conjunction with an increase in the utilization of flow cytometry (77.2% in 2005-2006; 97.0% in 2010-2011, p < 0.001). Using multivariable analysis, a positive pre-heart transplantation panel reactive antibody by flow cytometry independently predicted graft loss.CONCLUSIONS:
There has been a recent increase in flow cytometric assessment of human leukocyte antibodies prior to heart transplantation, which may be associated with an increase in the prevalence of pre-transplant patients being characterized as allosensitized. Flow cytometry may identify patients with the highest likelihood of graft loss.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Cuidados Pré-Operatórios
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Teste de Histocompatibilidade
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Transplante de Coração
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Rejeição de Enxerto
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Sobrevivência de Enxerto
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Antígenos HLA
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Isoanticorpos
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Estados Unidos