HLA alloimmunization in patients requiring ventricular assist device support

McKenna, David H.; Eastlund, Ted; Segall, Miriam; Noreen, Harriet; Park, Soon

doi:10.1016/s1053-2498(02)00448-5

Cited by 82 publications

(71 citation statements)

References 23 publications

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“…It is known that implantation of LVAD is associated with an increased risk of development of circulating anti-HLA class I and II antibodies (sensitization), detected by panel reactive antibody (20). The increased formation of HLA antibodies and the susceptibility to systemic infections are sustained by an immune dysfunction secondary to VAD implantation (21).…”

Section: Allosensitizationmentioning

confidence: 99%

Role of paediatric assist device in bridge to transplant

Hetzer¹,

Mfdm²,

2018

Ann. Cardiothorac. Surg.

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Section: Allosensitizationmentioning

confidence: 99%

Role of paediatric assist device in bridge to transplant

Hetzer¹,

Mfdm²,

2018

Ann. Cardiothorac. Surg.

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“…Left ventricular assist devices are a recognized risk factor for sensitization of patients awaiting cardiac transplantation [7][8][9] . The negative impact of anti -HLA antibodies on post -transplant allograft function and survival has now been well documented.…”

Section: Discussionmentioning

confidence: 99%

“…The negative impact of anti -HLA antibodies on post -transplant allograft function and survival has now been well documented. Recently, there has been accumulating evidence of various non -HLA antibodies involvement in decreased allograft and recipient survival [5][6][7][8][9][10] . While anti -HLA antibodies exert their negative effect via complement activation and antibody -mediated cytotoxicity, antibodies against AT1R, act as a natural allosteric receptor agonist.…”

Section: Discussionmentioning

confidence: 99%

The impact of Angiotensin II Type 1 Receptor antibodies on morbidity and mortality in Heart Mate II supported recipients

Urban¹,

Slavčev²,

Gazdic³

et al. 2016

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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, Peter Ivak a , Ivan Netuka a Aims. One of the proposed limitations of left ventricular assist device (LVAD) therapy is high degree of sensitization. Apart from human leukocyte antigen (HLA), antibodies against Angiotensin II Type 1 Receptor (AT1R) have been associated with adverse outcomes. The purpose of this study was to compare complications and survival of anti -AT1R positive versus negative Heart Mate II (HMII) recipients. Methods. Altogether 96 patients received HMII at our institution between 2008 and 2012. These were stratified into three groups: antibody positive before implantation (AT1R+), antibody conversion during support (AT1R-/+) and patients who remained antibody negative (AT1R-). Survival, major on-device adverse events and post-transplant rejections were assessed with Kaplan-Meier and log-rank tests.Results. Two year on-device and overall survival was 78 ± 12% and 75 ± 10% in AT1R-, 60 ± 23% and 60 ± 15% in AT1R+ and 92 ± 6% and 87 ± 5% in AT1R-/+ group (P = 0.409, P = 0.185). Freedom from major adverse event at two years for AT1R-, AT1R+ and AT1R-/+ was 49 ± 14%, 53 ± 16% and 41 ± 11% (P = 0.875). Freedom from rejection was 63 ± 17% in patients who were both anti-AT1R and HLA negative and 65 ± 13% in those who were antibody positive (P = 0.788). Conclusion.Patients who were anti-AT1R antibody positive had similar on-device survival and rate of complications in comparison to those who were antibody negative. In transplanted patients, there were no differences in the overall survival and rejection between the groups.

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“…One source of sensitization to HLA antigens is transfusion, and this group also reported an average of 148 units of blood products on the HeartMate, although the association was limited to transfusion associated with the LVAD and not remote blood product support. During the next few years, other groups also reported that VAD implantation was associated with allosensitization [7][8][9].…”

Section: Volume Displacement Pumpsmentioning

confidence: 99%

Allosensitization and the Ventricular Assist Device: Dual Evolution of Technology

Coppage¹

2013

Recent Advances in the Field of Ventricular Assist Devices

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HLA alloimmunization in patients requiring ventricular assist device support

Cited by 82 publications

References 23 publications

Role of paediatric assist device in bridge to transplant

Role of paediatric assist device in bridge to transplant

The impact of Angiotensin II Type 1 Receptor antibodies on morbidity and mortality in Heart Mate II supported recipients

Allosensitization and the Ventricular Assist Device: Dual Evolution of Technology

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