PMID- 12431496
OWN - NLM
STAT- MEDLINE
DCOM- 20030307
LR  - 20220316
IS  - 1053-2498 (Print)
IS  - 1053-2498 (Linking)
VI  - 21
IP  - 11
DP  - 2002 Nov
TI  - HLA alloimmunization in patients requiring ventricular assist device support.
PG  - 1218-24
AB  - BACKGROUND: Ventricular assist devices (VADs) are often necessary to maintain 
      circulation in patients with heart failure prior to cardiac transplantation. 
      However, the use of such devices has been reported to be associated with a high 
      incidence of development of human leukocyte antigen (HLA) antibodies, due 
      perhaps, according to some investigators, to immune-activating properties of the 
      VAD itself. We looked at HLA antibody formation in our patients during VAD 
      support to determine the rate and potential causes of antibody formation. 
      METHODS: Between 1995 and 2000, 54 patients were placed on a VAD at our 
      institution. We reviewed clinical and blood transfusion history and HLA antibody 
      testing of the 29 patients without HLA antibodies prior to implantation. HLA 
      antibody testing was performed by an anti-globulin-augmented cytotoxicity method 
      or by a commercial enzyme-linked immunoassay (ELISA) kit. RESULTS: Eight of 29 
      patients (28%) developed HLA antibodies. Patients who developed HLA antibodies 
      after VAD implantation received significantly more total peri- and post-operative 
      transfusions than did those who remained negative (99 transfusions vs 34 
      transfusions, p = 0.0014). Within this small study group, gender, age, etiology 
      of heart failure, previous cardiac surgery and duration of VAD support showed no 
      statistically significant correlation with formation of HLA antibodies. 
      CONCLUSIONS: Our data suggest that HLA alloimmunization during VAD support may be 
      due to extensive blood transfusion. The rate of HLA alloimmunization does not 
      appear to be greater than that reported in other populations of multi-transfused 
      patients. Leukoreduction of cellular components, as well as plasma, or other 
      initiatives is needed to reduce the rate of alloimmunization and, potentially, 
      the wait to transplantation.
FAU - McKenna, David H Jr
AU  - McKenna DH Jr
AD  - Department of Laboratory Medicine and Pathology, University of Minnesota Medical 
      School, Minneapolis, Minnesota 55455, USA. mcken020@umn.edu
FAU - Eastlund, Ted
AU  - Eastlund T
FAU - Segall, Miriam
AU  - Segall M
FAU - Noreen, Harriet J
AU  - Noreen HJ
FAU - Park, Soon
AU  - Park S
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adult
MH  - Blood Transfusion
MH  - Cytotoxicity Tests, Immunologic
MH  - Enzyme-Linked Immunosorbent Assay
MH  - Female
MH  - HLA Antigens/analysis/*immunology
MH  - *Heart-Assist Devices
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Time Factors
EDAT- 2002/11/15 04:00
MHDA- 2003/03/08 04:00
CRDT- 2002/11/15 04:00
PHST- 2002/11/15 04:00 [pubmed]
PHST- 2003/03/08 04:00 [medline]
PHST- 2002/11/15 04:00 [entrez]
AID - S1053249802004485 [pii]
AID - 10.1016/s1053-2498(02)00448-5 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2002 Nov;21(11):1218-24. doi: 
      10.1016/s1053-2498(02)00448-5.