Impact of Sex in the Efficacy of Perioperative Desensitization Procedures in Heart Transplantation: A Retrospective Cohort Study.
Adult
Biomarkers
Biopsy
Desensitization, Immunologic
/ methods
Female
Follow-Up Studies
Graft Rejection
/ immunology
HLA Antigens
/ immunology
Heart Transplantation
/ adverse effects
Humans
Immunosuppressive Agents
/ administration & dosage
Male
Middle Aged
Perioperative Care
/ methods
Pregnancy
Prognosis
Retrospective Studies
Sex Factors
Treatment Outcome
antibody mediated allograft rejection
desensitization
gender inequalities
heart transplant
sex influence
Journal
Frontiers in immunology
ISSN: 1664-3224
Titre abrégé: Front Immunol
Pays: Switzerland
ID NLM: 101560960
Informations de publication
Date de publication:
2021
2021
Historique:
received:
19
02
2021
accepted:
18
06
2021
entrez:
26
7
2021
pubmed:
27
7
2021
medline:
1
10
2021
Statut:
epublish
Résumé
Sensitized patients, i.e. recipients with preformed donor-specific HLA antibodies (pfDSA), are at high-risk of developing antibody-mediated rejections (AMR) and dying after heart transplantation (HTx). Perioperative desensitization procedures are associated with better outcomes but can cause sensitization, which may influence their efficacy. In sensitized patients (pfDSA>1000 mean immunofluorescence (MFI) units), we assessed the effect of perioperative desensitization by comparing treated patients to a historical control cohort. Multivariable survival analyses were performed on the time to main outcome, a composite of death and biopsy-proven AMR with 5-year follow-up. The study included 68 patients: 31 control and 37 treated patients. There was no difference in preoperative variables between the two groups, including cumulative pfDSA [4026 (1788;8725) Perioperative desensitization was associated with fewer AMR and deaths after HTx, and efficacy was more pronounced in men than women.
Sections du résumé
Background
Sensitized patients, i.e. recipients with preformed donor-specific HLA antibodies (pfDSA), are at high-risk of developing antibody-mediated rejections (AMR) and dying after heart transplantation (HTx). Perioperative desensitization procedures are associated with better outcomes but can cause sensitization, which may influence their efficacy.
Methods
In sensitized patients (pfDSA>1000 mean immunofluorescence (MFI) units), we assessed the effect of perioperative desensitization by comparing treated patients to a historical control cohort. Multivariable survival analyses were performed on the time to main outcome, a composite of death and biopsy-proven AMR with 5-year follow-up.
Results
The study included 68 patients: 31 control and 37 treated patients. There was no difference in preoperative variables between the two groups, including cumulative pfDSA [4026 (1788;8725)
Conclusion
Perioperative desensitization was associated with fewer AMR and deaths after HTx, and efficacy was more pronounced in men than women.
Identifiants
pubmed: 34305891
doi: 10.3389/fimmu.2021.659303
pmc: PMC8292826
doi:
Substances chimiques
Biomarkers
0
HLA Antigens
0
Immunosuppressive Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
659303Informations de copyright
Copyright © 2021 Nguyen, Salem, Bories, Coutance, Amour, Bougle, Suberbielle, Kheav, Carmagnat, Rouvier, Kirsch, Varnous, Leprince and Saheb.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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