Prevalence and risks of allosensitization in HeartMate left ventricular assist device recipients: The impact of leukofiltered cellular blood product transfusions

Abstract

Sensitization becomes more prevalent with increasing length of support. Avoidance of perioperative leukocyte-filtered cellular blood product transfusions does not decrease the incidence or degree of HLA sensitization. Conversely, cellular blood product transfusions may be associated with lessened alloimmunization and may mitigate the sensitization seen in recipients of the HeartMate left ventricular assist device as a bridge to transplantation.

Allosensitization in bridge to transplant Novacor left ventricular assist device patients: analysis of long-term outcomes with regard to acute rejection and chronic allograft vasculopathy☆

“…We have no likely explanation for this figure, which is higher that the 5-10% rate generally found in an immunologically naïve population [20,22].…”

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

“…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.…”

“…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.…”

Allosensitization and the Ventricular Assist Device: Dual Evolution of Technology

“…Finally, they postulate that immunogenic component(s) of the LVAD cause development of antibody directed against or cross-reactive with HLA antigens. The same group [11] later presented a larger cohort of HeartMate recipient (n=71) analyzing the effect of leuko-reduced blood products, but found no significant effect. Our laboratory [12] reported a series of 55 VAD recipients, most of whom had received a pulsatile device.…”