PMID- 11568025
OWN - NLM
STAT- MEDLINE
DCOM- 20011004
LR  - 20190623
IS  - 1524-4539 (Electronic)
IS  - 0009-7322 (Linking)
VI  - 104
IP  - 12 Suppl 1
DP  - 2001 Sep 18
TI  - Does histocompatibility affect homograft valve function after the Ross procedure?
PG  - I25-8
AB  - BACKGROUND: Homograft valves have been shown to be immunogenic, but it is unknown 
      whether this affects valve function. Therefore, we prospectively studied the 
      degree of histoincompatibility (defined as the number of human leukocyte antigen 
      [HLA] mismatches between valve donor and recipient) and the response of the 
      recipient (measured by antibodies against HLA) in relation to echocardiographic 
      parameters of homograft valve function after the Ross procedure. METHODS AND 
      RESULTS: Twenty-six patients (mean age 41+/-14 years; 20 males, 6 females) and 
      the cryopreserved pulmonary homograft valves that were implanted during a Ross 
      procedure were typed for HLA-A, HLA-B, and HLA-DR. After a mean follow-up of 
      15+/-6 months, 14 (54%) of the patients were anti-HLA class I antibody positive. 
      In all but 1 patient, these antibodies were shown to be donor specific. During 
      follow-up, there was a significant increase of the maximal (+6.2+/-7.1 mm Hg) and 
      mean (+3.2+/-4.3 mm Hg) transhomograft pressure gradients but not of homograft 
      regurgitation. Neither the number of HLA mismatches nor antibody status was found 
      to have significant impact on homograft valve function. In a multivariate 
      analysis, smaller homograft size (P=0.001) and younger recipient age (P=0.044) 
      were shown to be significantly associated with increased transhomograft pressure 
      gradients. CONCLUSIONS: Implantation of a cryopreserved pulmonary homograft 
      during the Ross procedure can induce a specific humoral response. We observed a 
      significant increase of the transhomograft pressure gradients within 15+/-6 
      months after surgery. For this period, we were unable to demonstrate a 
      relationship between this increase and the degree of histoincompatibility.
FAU - Bechtel, J F
AU  - Bechtel JF
AD  - Clinic for Cardiac Surgery, Institute for Immunology and Transfusion Medicine, 
      Medical University of Luebeck, Luebeck, Germany.
FAU - Bartels, C
AU  - Bartels C
FAU - Schmidtke, C
AU  - Schmidtke C
FAU - Skibba, W
AU  - Skibba W
FAU - Muller-Steinhardt, M
AU  - Muller-Steinhardt M
FAU - Kluter, H
AU  - Kluter H
FAU - Sievers, H H
AU  - Sievers HH
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
RN  - 0 (Autoantibodies)
RN  - 0 (HLA-A Antigens)
RN  - 0 (HLA-B Antigens)
RN  - 0 (HLA-DR Antigens)
RN  - 0 (Histocompatibility Antigens Class I)
SB  - IM
MH  - Adult
MH  - Aortic Valve/*physiopathology/surgery
MH  - Autoantibodies/blood
MH  - Blood Pressure
MH  - *Cardiac Surgical Procedures
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - HLA-A Antigens/immunology
MH  - HLA-B Antigens/immunology
MH  - HLA-DR Antigens/immunology
MH  - Heart Valve Diseases/blood/*immunology/surgery
MH  - Heart Valve Prosthesis Implantation
MH  - Histocompatibility/*immunology
MH  - Histocompatibility Antigens Class I/immunology
MH  - Histocompatibility Testing
MH  - Humans
MH  - Male
MH  - Prospective Studies
MH  - Pulmonary Valve/*immunology/*transplantation
MH  - Transplantation, Homologous/immunology
EDAT- 2001/09/25 10:00
MHDA- 2001/10/05 10:01
CRDT- 2001/09/25 10:00
PHST- 2001/09/25 10:00 [pubmed]
PHST- 2001/10/05 10:01 [medline]
PHST- 2001/09/25 10:00 [entrez]
AID - 10.1161/hc37t1.094899 [doi]
PST - ppublish
SO  - Circulation. 2001 Sep 18;104(12 Suppl 1):I25-8. doi: 10.1161/hc37t1.094899.