545: Impact of pretransplant statin treatment on sensitization and crossmatch results of cardiac allograft recipients
| Autor: | S. Reverdin, Branislav Radovancevic, Ronald H. Kerman, O.H. Frazier, Thuydung Tu, A. Hoover, E. Varughese, B. Victor, Rajko Radovancevic, K. Hosek, Stanislaw M. Stepkowski |
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| Rok vydání: | 2007 |
| Předmět: |
Pulmonary and Respiratory Medicine
Transplantation medicine.medical_specialty Statin medicine.diagnostic_test biology Cholesterol medicine.drug_class business.industry Lymphocyte Human leukocyte antigen Gastroenterology Flow cytometry chemistry.chemical_compound medicine.anatomical_structure chemistry Internal medicine medicine biology.protein Surgery Antibody Cardiology and Cardiovascular Medicine business Sensitization |
| Zdroj: | The Journal of Heart and Lung Transplantation. 26:S256 |
| ISSN: | 1053-2498 |
| DOI: | 10.1016/j.healun.2006.11.569 |
| Popis: | Purpose: HMG-CoA reductase inhibitors, statins, are used to treat patients for elevated serum cholesterol and triglycerides. Statins have been reported to improve heart and renal allograft survivals. Statins may also be immunomodulatory, in that they may reduce the presence of lymphocyte reactive antibodies, positive recipient-donor crossmatches and alter the expression of HLA antigens. Methods and Materials: We therefore evaluated the effect of statin treatment before cardiac transplantation on the presence of Flow PRA identified HLA antibodies and pretransplant flow cytometry crossmatch results. We studied 67 patients treated with statins and 108 untreated patients prior to cardiac transplantation. Results: Of the statin treated patients 75% (50/67) presented with a Flow PRA 5 % compared to 55% (59/108) of the untreated patients, p 0.02. Patients with a positive blood transfusion history (as a source of allosensitization) treated with statins vs no statins presented with an HLA class I PRA of 14 10 % vs 48 20% and an HLA class II PRA of 21 8% vs 36 19%, p 0.02 for both HLA class I and II PRAs, respectively. Although all patients were antihuman globulin (AHG) pretransplant crossmatch negative 37 % (40/108) of untreated vs 9% (6/67) of statin treated patients displayed positive flow cytometry crossmatches, p 0.001. Of great interest is the fact that graft loss at 12 months posttransplant is 8.1 % for statin treated compared to 15.7% for untreated recipients. Conclusions: Our data suggest that besides impacting cholesterol and triglycerides statin treatment before cardiac transplantation results in fewer at risk sensitized patients displaying significantly reduced HLA class I and II HLA antibodies and a reduced frequency of positive flow cytometry crossmatches. Therefore, statins may alter the expression of HLA antigens resulting in fewer sensitized patients displaying a reduced level of at risk sensitization. The mechanism of these observed statin immunomodulations requires further study. |
| Databáze: | OpenAIRE |
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