HLA antibodies in pediatric heart transplantation

Ho EK, Vasilescu ER, Vlad G, Marboe CC, Addonizio LJ, Suciu‐Foca N. HLA antibodies in pediatric heart transplantation. Pediatr Transplantation 2011: 15: 458–464. © 2011 John Wiley & Sons A/S. Abstract: We have analyzed the impact of anti‐HLA antibodies present in the patients’ circulation prior and/or following heart transplantation in a population of 108 pediatric recipients. Anti‐HLA class I and class II antibodies were monitored by traditional CDC using donor and panel T and B lymphocytes and by SPA for detection of DSA. There was a highly significant correlation between the development of AMR and presence of CDC‐ or SPA‐detected DSA. However, the fraction of the transplant population which remained AMR‐free was much higher among patients with SPA‐detected compared to CDC‐detected DSA. Furthermore, long‐term graft survival was negatively affected only by cytotoxic, complement‐fixing anti‐HLA class I antibodies developing following transplantation. Anti‐HLA class I or class II antibodies detected by SPA had no effect on long‐term survival rates.