A prospective analysis of the immunogenicity of cryopreserved nonvalved allografts used in pediatric heart surgery.
| Autor: | Breinholt JP 3rd; Department of Pediatrics, Primary Children's Medical Center and the University of Utah, Salt Lake City 84113, USA., Hawkins JA, Lambert LM, Fuller TC, Profaizer T, Shaddy RE |
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| Jazyk: | angličtina |
| Zdroj: | Circulation [Circulation] 2000 Nov 07; Vol. 102 (19 Suppl 3), pp. III179-82. |
| DOI: | 10.1161/01.cir.102.suppl_3.iii-179 |
| Abstrakt: | Background: The purpose of this study was to prospectively determine the immunogenicity of nonvalved allograft tissue used to repair congenital heart defects. Methods and Results: We prospectively analyzed the immune response of 11 children, 1.4 months to 10 years of age, who required nonvalved allografts to alleviate stenosis during repair of congenital heart defects. In 7 patients, pulmonary arterial grafts were used; in 3 patients, monocusp pulmonary artery grafts were used; and in 1 patient, a section of glutaraldehyde-preserved allograft pericardium was used. We measured the level of HLA panel-reactive antibody (PRA) before surgery, 1 week after, 1 month after, and 3 months after surgery. PRA was determined by the antiglobulin technique and flow cytometry. HLA class I and class II antibodies measured by either technique were negligible before and 1 week after surgery. Nine of 11 patients (82%) exhibited a significant immune response at 1 month after surgery that further increased at 3 months. The measured PRA for class I antibodies with the antiglobulin technique increased to 43+/-36% at 1 month and to 69+/-38% at 3 months after surgery. Flow cytometry class I PRA measurements were similar. Class II PRA increased to 26+/-34% at 1 month and to 41+/-36% at 3 months. Age negatively correlated with the degree of elevation of PRA, but neither allograft area nor the area indexed to patient body surface area correlated with PRA. Conclusions: Cryopreserved nonvalved allografts induce a strong HLA antibody response in the majority of children. |
| Databáze: | MEDLINE |
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