Infection is still a leading cause of death during the first year after heart transplantation. We evaluated the pre-transplant levels of HLA (Human Leukocyte antigen) - G molecules as a means of identifying heart recipients at risk of serious infections. We prospectively analyzed 122 adult heart transplant (HT) recipients. Serum samples were collected beforetransplantation and analyzed for sHLA-G levels by ELISA assay. The clinical follow-up period lasted 5 years. Clinical outcomes were bacterial infections requiring intravenous anti-microbial agents, cytomegalovirus (CMV) disease, and fungal infections requiring therapy. We found that 39 patients (32%) developed at least 1 serious bacterial infection. Higher pre-transplant sHLA-G levels were a risk factor for serious infection (above median value 5.4 ng/ml; relative risk 3.70; 95% confidence interval 1.03-12.64; p = 0.043). Patients with high levels of pre-transplant sHLA-G are also characterized by a lower overall survival at 5 years (p = 0.017), with microbial infections as major causes of death. No association was observed with the development rejection episode. Early monitoring of sHLA-G molecules proved useful for the identification of heart recipients who are at risk of serious infections.

中文翻译：

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可溶性HLA-G移植前水平可确定心脏移植受者发生感染的风险。

在心脏移植后的第一年，感染仍然是主要的死亡原因。我们评估了HLA（人类白细胞抗原）-G分子的移植前水平，以此来识别有严重感染风险的心脏接受者。我们前瞻性分析了122位成人心脏移植（HT）接受者。移植前收集血清样品，并通过ELISA测定分析sHLA-G水平。临床随访期为5年。临床结果是需要静脉注射抗微生物剂的细菌感染，巨细胞病毒（CMV）疾病和需要治疗的真菌感染。我们发现39名患者（32％）至少发展了1次严重细菌感染。较高的移植前sHLA-G水平是造成严重感染的危险因素（中位值5.4 ng / ml以上；相对危险度3.70；95％置信区间1.03-12.64; p = 0.043）。移植前sHLA-G水平高的患者，其特征还在于其5年总生存期较低（p = 0.017），其中微生物感染是主要的死亡原因。没有观察到与发育排斥发作的关联。sHLA-G分子的早期监测被证明可用于识别有严重感染风险的心脏接受者。