PMID- 24469294
OWN - NLM
STAT- MEDLINE
DCOM- 20141217
LR  - 20140430
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Linking)
VI  - 60
IP  - 3
DP  - 2014 May-Jun
TI  - Human leukocyte antigen sensitization in pediatric patients exposed to mechanical 
      circulatory support.
PG  - 317-21
LID - 10.1097/MAT.0000000000000053 [doi]
AB  - Human leukocyte antigen (HLA) sensitization of pediatric heart recipients 
      increases their risk of rejection and graft loss. As more children are placed on 
      mechanical circulatory support (MCS) as a bridge to transplant, the risk factors 
      for development of sensitization warrant further study. A single-center 
      retrospective review of 36 children who received MCS identified 22 patients 
      supported with either extracorporeal membrane oxygenation (ECMO) (n = 15) or 
      ECMO-ventricular assist device (VAD) (n = 7) with paired (pre-MCS/post-MCS) panel 
      reactive antibodies (PRA) or only negative post-MCS PRAs. Four patients (18%) 
      became sensitized post-MCS (one ECMO-only patient, three ECMO-VAD patients). No 
      difference was found between sensitized and nonsensitized patients in terms of 
      congenital heart disease versus primary cardiomyopathy (p = 0.096), duration of 
      MCS (38 days vs. 14 days, p = 0.233), or volume of blood product transfusions 
      (358.6 ml/kg vs. 612.7 ml/kg, p = not significant). By multivariable analysis, 
      the association of sensitization with older age at MCS (p = 0.076) and history of 
      homograft (p = 0.064) approached significance. Pediatric patients supported with 
      MCS are at low risk of developing HLA sensitization. Diagnosis, MCS duration, and 
      volume of transfused blood products do not appear to be associated with HLA 
      sensitization, but there is a suggestion of an association with older age at MCS 
      and history of a homograft.
FAU - Hong, Borah J
AU  - Hong BJ
AD  - From the *Division of Pediatric Cardiology, Texas Children's Hospital, Baylor 
      College of Medicine, Houston, Texas; daggerPuget Sound Blood Center, Seattle, 
      Washington; double daggerUniversity of Washington School of Medicine, Seattle, Washington; 
       section signDivision of Pediatric Cardiothoracic Surgery, Seattle Children's Hospital, 
      University of Washington, Seattle, Washington; and  paragraph signDivision of Pediatric 
      Cardiology, Seattle Children's Hospital, University of Washington, Seattle, 
      Washington.
FAU - Delaney, Meghan
AU  - Delaney M
FAU - Guynes, Anthony
AU  - Guynes A
FAU - Warner, Paul
AU  - Warner P
FAU - McMullan, David M
AU  - McMullan DM
FAU - Kemna, Mariska S
AU  - Kemna MS
FAU - Boucek, Robert J
AU  - Boucek RJ
FAU - Law, Yuk M
AU  - Law YM
LA  - eng
PT  - Journal Article
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
RN  - 0 (Antibodies)
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Antibodies/chemistry
MH  - Blood Transfusion
MH  - Cardiomyopathies/therapy
MH  - Child
MH  - Child, Preschool
MH  - Extracorporeal Membrane Oxygenation/*methods
MH  - Female
MH  - HLA Antigens/*chemistry
MH  - Heart Defects, Congenital/therapy
MH  - Heart Failure/congenital/*therapy
MH  - Heart Transplantation/*methods
MH  - Heart-Assist Devices/adverse effects
MH  - Humans
MH  - Infant
MH  - Male
MH  - Multivariate Analysis
MH  - Retrospective Studies
MH  - Risk Factors
EDAT- 2014/01/29 06:00
MHDA- 2014/12/18 06:00
CRDT- 2014/01/29 06:00
PHST- 2014/01/29 06:00 [entrez]
PHST- 2014/01/29 06:00 [pubmed]
PHST- 2014/12/18 06:00 [medline]
AID - 10.1097/MAT.0000000000000053 [doi]
PST - ppublish
SO  - ASAIO J. 2014 May-Jun;60(3):317-21. doi: 10.1097/MAT.0000000000000053.