BACKGROUND: The clinical relevance of the post-transplant presence of anti-major histocompatibility complex class I chain-related A (MICA) antibodies as a marker for chronic graft failure in heart transplantation was examined using post-transplant sera from 159 heart transplant recipients. Mean follow-up after transplantation was 7 +/- 4.9 years. METHODS: The sera were screened by Luminex (Luminex Corp, Austin, TX) for MICA antibodies. Samples that tested positive were confirmed using a Luminex MICA single-antigen bead assay. The antigen specificity of the detected antibodies was identified. Outcome parameters were survival, cardiac allograft vasculopathy (CAV), and cellular rejection. RESULTS: We retrospectively selected 159 patients: 107 with 0 or 1 rejection and 52 with 2 or more acute rejection episodes, of whom 36 (22.6%) had a positive screen for anti-MICA antibodies. In 19 of 36 samples, specific anti-MICA antibodies were confirmed by single antigen assay. The presence of post-transplant specified anti-MICA antibodies in patients' sera was associated with acute rejection (63.2% vs 28.6%, p < 0.01) and CAV (78.9% vs 32.8%, p < 0.01). Multivariate analysis identified anti-MICA positivity as an independent risk factor for the development of CAV. CONCLUSIONS: The results indicate that anti-MICA antibodies may be related to adverse outcome after heart transplantation. Post-transplantation monitoring of anti-MICA antibodies could identify patients with an increased risk for acute rejection and vasculopathy.
BACKGROUND: The clinical relevance of the post-transplant presence of anti-major histocompatibility complex class I chain-related A (MICA) antibodies as a marker for chronic graft failure in heart transplantation was examined using post-transplant sera from 159 heart transplant recipients. Mean follow-up after transplantation was 7 +/- 4.9 years. METHODS: The sera were screened by Luminex (Luminex Corp, Austin, TX) for MICA antibodies. Samples that tested positive were confirmed using a Luminex MICA single-antigen bead assay. The antigen specificity of the detected antibodies was identified. Outcome parameters were survival, cardiac allograft vasculopathy (CAV), and cellular rejection. RESULTS: We retrospectively selected 159 patients: 107 with 0 or 1 rejection and 52 with 2 or more acute rejection episodes, of whom 36 (22.6%) had a positive screen for anti-MICA antibodies. In 19 of 36 samples, specific anti-MICA antibodies were confirmed by single antigen assay. The presence of post-transplant specified anti-MICA antibodies in patients' sera was associated with acute rejection (63.2% vs 28.6%, p < 0.01) and CAV (78.9% vs 32.8%, p < 0.01). Multivariate analysis identified anti-MICA positivity as an independent risk factor for the development of CAV. CONCLUSIONS: The results indicate that anti-MICA antibodies may be related to adverse outcome after heart transplantation. Post-transplantation monitoring of anti-MICA antibodies could identify patients with an increased risk for acute rejection and vasculopathy.
Authors: Carrie L Butler; Michelle J Hickey; Ning Jiang; Ying Zheng; David Gjertson; Qiuheng Zhang; Ping Rao; Gregory A Fishbein; Martin Cadeiras; Mario C Deng; Hector L Banchs; Guillermo Torre; David DeNofrio; Howard J Eisen; Jon Kobashigawa; Randall C Starling; Abdallah Kfoury; Adrian Van Bakel; Gregory Ewald; Ivan Balazs; Arnold S Baas; Daniel Cruz; Reza Ardehali; Reshma Biniwale; Murray Kwon; Abbas Ardehali; Ali Nsair; Bryan Ray; Elaine F Reed Journal: Am J Transplant Date: 2020-04-26 Impact factor: 8.086
Authors: Michal Pazdernik; Helena Bedanova; Zhi Chen; Josef Kautzner; Vojtech Melenovsky; Ivan Malek; Antonij Slavcev; Michaela Bartonova; Vladimir Karmazin; Tomas Eckhardt; Ales Tomasek; Eva Ozabalova; Tomas Kovarnik; Peter Wohlfahrt; Milan Sonka Journal: Transpl Immunol Date: 2020-10-15 Impact factor: 2.032