Human Leukocyte Antigen Antibody Sampling in Ventricular Assist Device Recipients: Are We Talking?

Adult Antibodies Child HLA Antigens Heart Failure Heart Transplantation Heart-Assist Devices Humans Retrospective Studies

Journal

Transplantation proceedings
ISSN: 1873-2623
Titre abrégé: Transplant Proc
Pays: United States
ID NLM: 0243532

Informations de publication

Date de publication:
Sep 2021
Historique:
received: 15 04 2021
accepted: 19 07 2021
pubmed: 21 8 2021
medline: 26 11 2021
entrez: 20 8 2021
Statut: ppublish

Résumé

Ventricular assist devices (VADs) are commonly used as a bridge to transplantation but may yield HLA sensitization. We evaluated the prevalence of HLA antibody (Ab) sampling pre- and post-VAD placement in pediatric and adult patients and notification of VAD status to the HLA laboratory. All pediatric and adult patients who received a first-time VAD between 2005 and 2013 were included in this single-center retrospective review. Data were collected from the University of Alberta Hospital histocompatibility laboratory's information system and a local VAD database. In total, 106 patients were included (40 pediatric, median 3.0 years [interquartile range, 0.3-10.7]; 66 adult, 55.0 years [46.8-61.2]). HLA Ab sampling within 1-month pre-VAD occurred in 70% of pediatric and 79% of adult recipients (P = .215). Testing within 1 month of VAD placement occurred in 89% of pediatric and 67% of adult recipients (P = .012). For those with HLA Ab sampling within 30 days postimplant, notification to the HLA laboratory of VAD status occurred in 19 of 27 (70%) pediatric and 24 of 33 (73%) adult patients (P = .533). Of patients transplanted post VAD with HLA Ab samples collected, 12 of 28 (43%) and 13 of 38 (34%) adult recipients did not have notification of VAD status to the HLA laboratory (P = .322). There were inconsistencies in HLA Ab sampling and communication to the HLA laboratory surrounding VAD placement. Standardization of both HLA Ab assessment frequency after VAD implantation and communication regarding changes in clinical status and the occurrence of key sensitizing events such as VAD placement are imperative as patients await transplantation.

Sections du résumé

BACKGROUND BACKGROUND
Ventricular assist devices (VADs) are commonly used as a bridge to transplantation but may yield HLA sensitization. We evaluated the prevalence of HLA antibody (Ab) sampling pre- and post-VAD placement in pediatric and adult patients and notification of VAD status to the HLA laboratory.
METHODS METHODS
All pediatric and adult patients who received a first-time VAD between 2005 and 2013 were included in this single-center retrospective review. Data were collected from the University of Alberta Hospital histocompatibility laboratory's information system and a local VAD database.
RESULTS RESULTS
In total, 106 patients were included (40 pediatric, median 3.0 years [interquartile range, 0.3-10.7]; 66 adult, 55.0 years [46.8-61.2]). HLA Ab sampling within 1-month pre-VAD occurred in 70% of pediatric and 79% of adult recipients (P = .215). Testing within 1 month of VAD placement occurred in 89% of pediatric and 67% of adult recipients (P = .012). For those with HLA Ab sampling within 30 days postimplant, notification to the HLA laboratory of VAD status occurred in 19 of 27 (70%) pediatric and 24 of 33 (73%) adult patients (P = .533). Of patients transplanted post VAD with HLA Ab samples collected, 12 of 28 (43%) and 13 of 38 (34%) adult recipients did not have notification of VAD status to the HLA laboratory (P = .322).
CONCLUSIONS CONCLUSIONS
There were inconsistencies in HLA Ab sampling and communication to the HLA laboratory surrounding VAD placement. Standardization of both HLA Ab assessment frequency after VAD implantation and communication regarding changes in clinical status and the occurrence of key sensitizing events such as VAD placement are imperative as patients await transplantation.

Identifiants

DOI: 10.1016/j.transproceed.2021.07.025 PMID: 34412914
pubmed: 34412914
pii: S0041-1345(21)00498-X
doi: 10.1016/j.transproceed.2021.07.025
pii:
doi:

Substances chimiques

Antibodies 0
HLA Antigens 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2377-2381

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

Auteurs

Michael Khoury (M)

Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute (ATI), Edmonton, AB, Canada. Electronic address: Khoury1@ualberta.ca.

Tara Pidborochynski (T)

Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada.

Anne Halpin (A)

Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute (ATI), Edmonton, AB, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada; Canadian Donation and Transplantation Research Program (CDTRP), Edmonton, AB, Canada; Alberta Public Laboratories (APL), Edmonton, AB, Canada.

Patricia Campbell (P)

Alberta Transplant Institute (ATI), Edmonton, AB, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada; Canadian Donation and Transplantation Research Program (CDTRP), Edmonton, AB, Canada; Alberta Public Laboratories (APL), Edmonton, AB, Canada.

Simon Urschel (S)

Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute (ATI), Edmonton, AB, Canada; Canadian Donation and Transplantation Research Program (CDTRP), Edmonton, AB, Canada.

Daniel Kim (D)

Alberta Transplant Institute (ATI), Edmonton, AB, Canada; Department of Medicine, University of Alberta, Edmonton, AB, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB, Canada.

Lori West (L)

Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute (ATI), Edmonton, AB, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada; Canadian Donation and Transplantation Research Program (CDTRP), Edmonton, AB, Canada.

Holger Buchholz (H)

Department of Medicine, University of Alberta, Edmonton, AB, Canada; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB, Canada.

Jennifer Conway (J)

Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute (ATI), Edmonton, AB, Canada.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Human Leukocyte Antigen Antibody Sampling in...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Globulines › Sérum-globulines › Immunoglobulines › Anticorps › Human Leukocyte Antigen Antibody Sampling in...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Human Leukocyte Antigen Antibody Sampling in...
questionsmedicales.fr › Facteurs biologiques › Antigènes › Isoantigènes › Antigènes d'histocompatibilité › Antigènes HLA › Human Leukocyte Antigen Antibody Sampling in...
questionsmedicales.fr › Maladies cardiovasculaires › Cardiopathies › Défaillance cardiaque › Human Leukocyte Antigen Antibody Sampling in...
questionsmedicales.fr › Procédures de chirurgie opératoire › Transplantation › Transplantation d'organe › Transplantation cardiaque › Human Leukocyte Antigen Antibody Sampling in...
questionsmedicales.fr › Équipement et fournitures › Équipement chirurgical › Organes artificiels › Coeur artificiel › Dispositifs d'assistance circulatoire › Human Leukocyte Antigen Antibody Sampling in...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Human Leukocyte Antigen Antibody Sampling in...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Human Leukocyte Antigen Antibody Sampling in...