PMID- 15111175
OWN - NLM
STAT- MEDLINE
DCOM- 20040614
LR  - 20161124
IS  - 0003-4975 (Print)
IS  - 0003-4975 (Linking)
VI  - 77
IP  - 5
DP  - 2004 May
TI  - Mycophenolic mofetil reduces the HLA antibody response of children to valved 
      allograft implantation.
PG  - 1734-9; discussion 1739
AB  - BACKGROUND: Valved allografts induce a brisk, broadly reactive human leukocyte 
      antigen (HLA) antibody response in children after implantation. Mycophenolic 
      mofetil (MMF) is a powerful immunosuppressant that inhibits the proliferation of 
      both T cells and B cells and has been reported to possibly reduce HLA panel 
      reactive antibody (PRA) in sensitized transplant recipients. METHODS: The purpose 
      of this study was to determine whether MMF can blunt the HLA antibody response to 
      valved allografts in children. Eight patients completed (of 28 approached) a 
      pilot study to determine the effects of 3 months of twice daily MMF (600 
      mg/m(2)/dose) on the HLA antibody response measured before surgery, at 1 month, 
      and at 3 months after implantation. Patients were 7.5 +/- 4 yrs old (mean +/- 
      standard deviation [SD]), with 5 patients undergoing repair of tetralogy of 
      Fallot, 2 Ross procedures, and 1 aortic valve replacement. RESULTS: In contrast 
      to historical controls with a virtual 100% HLA class I PRA response to valved 
      allograft implantation, MMF markedly decreased the HLA class I antibody response 
      at 1 and 3 months postimplantation. In 6 cases where the HLA type of the donor 
      was defined, PRA specificity correlated with incompatible antigens on the 
      allograft. One patient withdrew after 2 weeks due to a sinus infection that was 
      successfully treated with oral antibiotics, and 3 patients had a transient 
      adverse effect of postoperative vomiting. CONCLUSIONS: This study demonstrates 
      the ability to pharmacologically abrogate the HLA class I antibody response to 
      valved allograft implantation in children using MMF.
FAU - Shaddy, Robert E
AU  - Shaddy RE
AD  - Department of Pediatrics, University of Utah School of Medicine and Primary 
      Children's Medical Center, Salt Lake City, Utah 84113, USA. robert.shaddy@ihc.com
FAU - Fuller, Thomas C
AU  - Fuller TC
FAU - Anderson, Jeffrey B
AU  - Anderson JB
FAU - Lambert, Linda M
AU  - Lambert LM
FAU - Brinkman, Maureen K
AU  - Brinkman MK
FAU - Profaizer, Tracie
AU  - Profaizer T
FAU - Hawkins, John A
AU  - Hawkins JA
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
RN  - 0 (Autoantibodies)
RN  - 0 (Histocompatibility Antigens Class I)
RN  - 0 (Histocompatibility Antigens Class II)
RN  - 0 (Immunosuppressive Agents)
RN  - HU9DX48N0T (Mycophenolic Acid)
SB  - IM
MH  - Antibody Formation/drug effects
MH  - Autoantibodies/*analysis
MH  - *Blood Vessel Prosthesis Implantation
MH  - Child
MH  - Child, Preschool
MH  - Heart Defects, Congenital/*surgery
MH  - *Heart Valve Prosthesis Implantation
MH  - Histocompatibility Antigens Class I/analysis/*immunology
MH  - Histocompatibility Antigens Class II/analysis/*immunology
MH  - Humans
MH  - Immunosuppressive Agents/*pharmacology
MH  - Mycophenolic Acid/*analogs & derivatives/*pharmacology
MH  - Pilot Projects
MH  - Transplantation, Homologous
EDAT- 2004/04/28 05:00
MHDA- 2004/06/15 05:00
CRDT- 2004/04/28 05:00
PHST- 2003/10/08 00:00 [accepted]
PHST- 2004/04/28 05:00 [pubmed]
PHST- 2004/06/15 05:00 [medline]
PHST- 2004/04/28 05:00 [entrez]
AID - S0003497503021878 [pii]
AID - 10.1016/j.athoracsur.2003.10.047 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2004 May;77(5):1734-9; discussion 1739. doi: 
      10.1016/j.athoracsur.2003.10.047.