Introduction

Recent studies suggested potential positive correlations between HLA-specific antibodies and development of cardiac allograft vasculopathy (CAV).

Methods

This prospective two-center study investigated early progression of CAV by coronary optical coherence tomography in 1 month and 12 months after heart transplantation (HTx) in 104 patients. Detection and characterization of donor specific (DSA) and MHC class-I polypeptide-related sequence A (MICA) antibodies were performed before, 1, 6 and 12 months after transplantation.

Results

During the first post-HTx year, we observed a significant reduction in the mean coronary luminal area (P < .001), and progression in mean intimal thickness (IT) (P < .001). DSA and anti-MICA occurred in 17% of all patients, but no significant relationship was observed between presence of DSA/anti-MICA and IT progression within 12 months after HTx. In contrast, we observed significant association between presence of DSA (p=0.031), de-novo DSA (p=0.031), HLA Class II DSA (p=0.017) and media thickness (MT) progression.

Conclusion

Results of our study did not identify a direct association between presence of DSA/anti-MICA and intimal thickness progression in an early period after HTx. However, we found significant relationships between DSA and media thickness progression that may identify a newly recognized immune-pathological aspect of CAV.

中文翻译：

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供体特异性抗 HLA 抗体和心脏移植血管病变：使用高度自动化的 3-D 光学相干断层扫描分析的前瞻性研究

介绍

最近的研究表明 HLA 特异性抗体与心脏同种异体移植血管病变 (CAV) 的发展之间存在潜在的正相关关系。

方法

这项前瞻性的两中心研究通过冠状动脉光学相干断层扫描在 104 名患者心脏移植 (HTx) 后 1 个月和 12 个月内调查了 CAV 的早期进展。在移植前、移植后 1、6 和 12 个月进行供体特异性 (DSA) 和 MHC I 类多肽相关序列 A (MICA) 抗体的检测和表征。

结果

在 HTx 后的第一年，我们观察到平均冠状动脉管腔面积显着减少 (P < .001)，平均内膜厚度 (IT) 增加 (P < .001)。17% 的患者出现 DSA 和抗 MICA，但在 HTx 后 12 个月内，DSA/抗 MICA 的存在与 IT 进展之间没有观察到显着相关性。相比之下，我们观察到 DSA (p=0.031)、新生 DSA (p=0.031)、HLA II 类 DSA (p=0.017) 和介质厚度 (MT) 进展之间存在显着关联。

结论

我们的研究结果未发现在 HTx 后早期 DSA/抗 MICA 的存在与内膜厚度进展之间存在直接关联。然而，我们发现 DSA 与介质厚度进展之间存在显着关系，这可能识别出新发现的 CAV 免疫病理学方面。