PMID- 31764892
OWN - NLM
STAT- MEDLINE
DCOM- 20200611
LR  - 20200611
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 103
IP  - 12
DP  - 2019 Dec
TI  - HLA Alloimmunization Following Ventricular Assist Device Support Across the Age 
      Spectrum.
PG  - 2715-2724
LID - 10.1097/TP.0000000000002798 [doi]
AB  - BACKGROUND: Ventricular assist device (VAD) therapy has become an important tool 
      for end-stage heart failure. VAD therapy has increased survival but is associated 
      with complications including the development of human leukocyte antigen (HLA) 
      antibodies. We sought to determine the incidence of HLA antibody development 
      post-VAD insertion, across the age spectrum, in patients receiving 
      leukocyte-reduced blood products, with standardized HLA antibody detection 
      methods and to investigate factors associated with antibody development. METHODS: 
      This was a retrospective analysis of all patients who underwent durable VAD 
      placement between 2005 and 2014. Inclusion criteria included availability of pre- 
      and post-VAD HLA antibody results. Associations between HLA antibody development 
      in the first-year postimplant and patient factors were explored. RESULTS: 
      Thirty-nine adult and 25 pediatric patients made up the study cohort. Following 
      implant, 31% and 8% of patients developed new class I and class II antibodies. 
      The proportion of newly sensitized patients was similar in adult and pediatric 
      patients. The class I HLA panel reactive antibody only significantly increased in 
      adults. Pre-VAD sensitization, age, sex (pediatrics), and transfusion were not 
      associated with the development of HLA antibodies. CONCLUSIONS: In a cohort of 
      VAD patients receiving leukocyte-reduced blood products and standardized HLA 
      antibody testing, roughly one-third developed new class I antibodies in the 
      first-year postimplant. Adults showed significantly increased class I panel 
      reactive antibody following VAD support. No patient-related factors were 
      associated with HLA antibody development. Larger prospective studies are required 
      to validate these findings and determine the clinical impact of these antibodies 
      following VAD insertion.
FAU - Halpin, Anne M
AU  - Halpin AM
AD  - Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
AD  - Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, 
      AB, Canada.
AD  - Alberta Transplant Institute (ATI), AB, Canada.
AD  - Canadian Donation and Transplantation Research Program (CDTRP), AB, Canada.
FAU - Nahirniak, Susan
AU  - Nahirniak S
AD  - Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, 
      AB, Canada.
FAU - Campbell, Patricia M
AU  - Campbell PM
AD  - Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, 
      AB, Canada.
AD  - Alberta Transplant Institute (ATI), AB, Canada.
FAU - Urschel, Simon
AU  - Urschel S
AD  - Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
AD  - Alberta Transplant Institute (ATI), AB, Canada.
AD  - Canadian Donation and Transplantation Research Program (CDTRP), AB, Canada.
AD  - Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada.
FAU - Kim, Daniel H
AU  - Kim DH
AD  - Alberta Transplant Institute (ATI), AB, Canada.
AD  - Department of Medicine, University of Alberta, Edmonton, AB, Canada.
AD  - Department of Surgery, University of Alberta, Edmonton, AB, Canada.
FAU - West, Lori J
AU  - West LJ
AD  - Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
AD  - Alberta Transplant Institute (ATI), AB, Canada.
AD  - Canadian Donation and Transplantation Research Program (CDTRP), AB, Canada.
AD  - Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada.
AD  - Department of Surgery, University of Alberta, Edmonton, AB, Canada.
AD  - Department of Medical Microbiology and Immunology, University of Alberta, 
      Edmonton, AB, Canada.
FAU - Pidorochynski, Tara
AU  - Pidorochynski T
AD  - Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
AD  - Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada.
FAU - Buchholz, Holger
AU  - Buchholz H
AD  - Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada.
AD  - Department of Medicine, University of Alberta, Edmonton, AB, Canada.
AD  - Mazankowski Heart Institute, University of Alberta, Edmonton, AB, Canada.
FAU - Conway, Jennifer
AU  - Conway J
AD  - Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
AD  - Alberta Transplant Institute (ATI), AB, Canada.
AD  - Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (HLA Antigens)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Follow-Up Studies
MH  - *Forecasting
MH  - HLA Antigens/*immunology
MH  - Heart Failure/immunology/*surgery
MH  - Heart-Assist Devices/*adverse effects
MH  - Humans
MH  - Infant
MH  - Isoantibodies/*immunology
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/etiology/*immunology
MH  - Retrospective Studies
EDAT- 2019/11/26 06:00
MHDA- 2020/06/12 06:00
CRDT- 2019/11/26 06:00
PHST- 2019/11/26 06:00 [entrez]
PHST- 2019/11/26 06:00 [pubmed]
PHST- 2020/06/12 06:00 [medline]
AID - 00007890-201912000-00037 [pii]
AID - 10.1097/TP.0000000000002798 [doi]
PST - ppublish
SO  - Transplantation. 2019 Dec;103(12):2715-2724. doi: 10.1097/TP.0000000000002798.