PMID- 15680851
OWN - NLM
STAT- MEDLINE
DCOM- 20050923
LR  - 20050131
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 79
IP  - 2
DP  - 2005 Feb
TI  - Panel-reactive antibodies late after allograft implantation in children.
PG  - 641-4; discussion 645
AB  - BACKGROUND: Circulating human leukocyte antigen (HLA) panel-reactive antibodies 
      (PRA > 10%) have been independently associated with increased risk of rejection 
      and mortality in patients who undergo cardiac transplantation. Cryopreserved 
      allografts used to repair heart defects induce broadly reactive HLA antibodies in 
      children that persist for an undetermined duration of time. The purpose of this 
      study was to prospectively determine the level of HLA sensitization several years 
      after implantation of cryopreserved allografts in children. METHODS: We conducted 
      late follow-up of 13 children previously screened for PRA before and after 
      implantation of valved and nonvalved allografts who are alive and free from 
      allograft replacement. Panel-reactive antibodies against HLA class I and II 
      antigens were determined using flow cytometry and classified as high reactive 
      (>50% PRA), low reactive (11% to 50%), or absent (0% to 10%). Follow-up PRA was 
      compared with PRA obtained 3 months after initial allograft implantation. 
      RESULTS: Elevated HLA class I PRA persisted at late follow-up in 12 of 13 
      children, although it decreased significantly from high to low or from low to 
      absent in 12 of 13 patients (p < 0.001). Elevated HLA class II PRA persisted at 
      late follow-up in 6 of 13 children (46%) and had decreased significantly from 
      prior levels (p = 0.011). CONCLUSIONS: Circulating HLA antibodies induced by 
      cryopreserved allograft tissue persist up to 8 years after implantation although 
      they decrease with time. Therefore, children who have received cryopreserved 
      allografts before cardiac transplantation may be at greater risk for transplant 
      rejection.
FAU - Hooper, David K
AU  - Hooper DK
AD  - Department of Pediatrics, University of Utah School of Medicine and Primary 
      Children's Medical Center, Salt Lake City, Utah 84113, USA.
FAU - Hawkins, John A
AU  - Hawkins JA
FAU - Fuller, Thomas C
AU  - Fuller TC
FAU - Profaizer, Tracie
AU  - Profaizer T
FAU - Shaddy, Robert E
AU  - Shaddy RE
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Child
MH  - Child, Preschool
MH  - Cryopreservation
MH  - Female
MH  - Follow-Up Studies
MH  - HLA Antigens/*immunology
MH  - Heart Defects, Congenital/surgery
MH  - Heart Valves/*transplantation
MH  - Humans
MH  - Infant
MH  - Male
MH  - Prospective Studies
MH  - Transplantation, Homologous/*immunology
EDAT- 2005/02/01 09:00
MHDA- 2005/09/24 09:00
CRDT- 2005/02/01 09:00
PHST- 2004/07/22 00:00 [accepted]
PHST- 2005/02/01 09:00 [pubmed]
PHST- 2005/09/24 09:00 [medline]
PHST- 2005/02/01 09:00 [entrez]
AID - S0003-4975(04)01617-0 [pii]
AID - 10.1016/j.athoracsur.2004.07.052 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2005 Feb;79(2):641-4; discussion 645. doi: 
      10.1016/j.athoracsur.2004.07.052.