This study aims to compare the immunogenicity of fresh decellularized with cryopreserved native heart valve allografts to identify potential immunological risks in subsequent organ transplantations. We measured the induction of allogeneic HLA class I and II specific antibodies and characterized donor‐specific antibodies by Luminex‐based single beads assay in both groups. Serum samples were collected before valve replacement, at 3 and 24 months postoperatively. Donor‐specific HLA antibodies were assessed positive if the mean fluorescent intensity (MFI) was >1000. Between November 2016 and April 2017 patients with fresh decellularized homografts (n = 4) and cryopreserved native homografts (n = 4) were analyzed. Patients receiving cryopreserved native allografts reacted with broad HLA‐specific antibody response. Antibodies were directed against mismatched HLA antigens of the donors but also against HLA specificities not present on the homograft with many antibodies having mean fluorescence intensity values >10 000. While HLA class I specific antibodies showed a significant increase (P = .002) in their MFI values on day 90, HLA class II specific antibodies did not show a significant increase (P = .069). In the fresh decellularized homografts group, no significant antibody induction was observed. Consequently, the native group presented significantly higher MFIs for HLA antibodies on day 90 compared with the patients receiving decellularized allografts (P = .021). No detectable HLA antibody response was observed after implantation of decellularized in comparison with cryopreserved native allografts. Lower immunogenicity as compared with native homografts might increase the chance of receiving a transplant if will be required later in the life of the patients.

中文翻译：

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新鲜脱细胞与冷冻保存的天然同种异体移植后的供体特异性HLA抗体

这项研究旨在比较新鲜的脱细胞与冷冻保存的天然心脏瓣膜同种异体移植物的免疫原性，以鉴定随后器官移植中的潜在免疫学风险。我们通过两组基于Luminex的单珠测定法测量了同种HLA I和II类HLA特异性抗体的诱导并鉴定了供体特异性抗体。术后3和24个月，在更换瓣膜之前收集血清样本。如果平均荧光强度（MFI）> 1000，则供体特异性HLA抗体被评估为阳性。在2016年11月至2017年4月之间，对新鲜脱细胞同种异体移植物（n = 4）和冷冻保存的天然同种异体移植物（n = 4）的患者进行了分析。接受冷冻保存的天然同种异体移植的患者会产生广泛的HLA特异性抗体反应。在第90天的MFI值中，P = .002），HLA II类特异性抗体没有显示出明显的增加（P = .069）。在新鲜的脱细胞同种异体移植组中，未观察到明显的抗体诱导。因此，与接受脱细胞同种异体移植的患者相比，该天然组在第90天呈现出明显更高的HLA抗体MFI（P = .021）。与冷冻保存的天然同种异体移植相比，植入脱细胞后未观察到可检测的HLA抗体反应。如果在患者生命后期需要，与天然同种异体移植相比，较低的免疫原性可能会增加接受移植的机会。