The Importance of Non-HLA Antibodies After Heart Transplant

AbstractPurpose of ReviewAntibodies to human leukocyte antigens (HLA) are associated with adverse patient and allograft outcomes after heart transplantation. Non-HLA antibodies have increasingly been recognized as important mediators of rejection, cardiac allograft vasculopathy (CAV), and allograft injury. In particular, these antibodies have been implicated in a subset of heart transplant recipients who have clinical and/or pathologic evidence of antibody-mediated rejection in the absence of detectable antibodies against HLA.Recent FindingsNon-HLA antigens have been identified to have important roles in both the innate and adaptive immune response in transplantation. These antigens are predominantly expressed on vascular endothelium of the donor heart and include major histocompatibility class I related chain A (MICA), G protein coupled receptor angiotensin II type 1 receptor (AT1R), cytoskeletal elements such as myosin and vimentin. A growing number of studies have demonstrated antibodies to these antigens in rejection and development of CAV. At present, non-HLA antibodies are not routinely monitored post-transplant, and laboratory evaluation remains non-standardized. Further investigation is required to improve the detection of non-HLA antibodies, define pathophysiological mechanisms involved in allograft injury, and better understand their impact on clinical outcomes.SummaryNon-HLA antibodies have been identified as important mediators of rejection, allograft dysfunction,...
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research

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This study aimed to define the ultrastructural changes of the endothelium in lung allografts in the setting of AMR and determine its specificity for AMR.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Original Clinical Science Source Type: research
ConclusionsHEARTBiT’s diagnostic performance compares favourably to the only currently approved, minimally-invasive diagnostic test to rule out ACR, AlloMap, and may be used to inform care decisions in the first 2 months post-transplantation, when AlloMap is not approved, and most ACR episodes occur.
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
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Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Original Clinical Science Source Type: research
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Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Original Clinical Science Source Type: research
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Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
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Source: Chinese Medical Journal - Category: General Medicine Authors: Tags: Chin Med J (Engl) Source Type: research
Acute rejection is one of the most important direct contributors of mortality after heart transplantation. Advances in the development of novel non-invasive approaches for the early identification of allograft rejection are necessary. We conducted a non-targeted proteome characterization focused on identifying multiple plasmatic protein differences to evaluate their diagnostic accuracy for rejection episodes.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Original Pre-Clinical Science Source Type: research
The objective of this study was to determine the association between azithromycin use, CLAD, acute rejection, airway inflammation, and bacterial microbiota composition and structure after LTx.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: ORIGINAL PRE-CLINICAL SCIENCE Source Type: research
The objective of this study was to determine the association between azithromycin use, CLAD, acute rejection, airway inflammation and bacterial microbiota composition and structure after LTx.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Original Pre-Clinical Science Source Type: research
Sustained, indolent immune injury of the vasculature of a heart transplant limits long-term graft and recipient survival. This injury is mitigated by a poorly characterized, maladaptive repair response. Vascular endothelial cells respond to proangiogenic cues in the embryo by differentiation to specialized phenotypes, associated with expression of apelin. In the adult, the role of developmental proangiogenic cues in repair of the established vasculature is largely unknown. We found that human and minor histocompatibility–mismatched donor mouse heart allografts with alloimmune-mediated vasculopathy upregulated express...
Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
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