Impacts of Pre-transplant Panel-Reactive Antibody on Post-transplantation Outcomes: A Study of Nationwide Heart Transplant Registry Data
Korean Journal of Transplantation(2023)
Abstract
Background and Objectives : The number of sensitized heart failure patients on waiting lists for heart transplantation (HTx) is increasing. Using the Korean Organ Transplantation Registry (KOTRY), a nationwide multicenter database, we investigated the prevalence and clinical impact of calculated panel -reactive antibody (cPRA) in patients undergoing HTx. Methods : We retrospectively reviewed 813 patients who underwent HTx between 2014 and 2021. Patients were grouped according to peak PRA level as group A: patients with cPRA <= 10% (n= 492); group B: patients with cPRA >10%, <50% (n=160); group C patients with cPRA >= 50% (n=161). Post-HTx outcomes were freedom from antibody -mediated rejection (AMR), acute cellular rejection, coronary allograft vasculopathy, and all -cause mortality. Results : The median follow-up duration was 44 (19-72) months. Female sex, retransplantation, and pre-HTx renal replacement therapy were independently associated with an increased risk of sensitization (cPRA >= 50%). Group C patients were more likely to have longer hospital stays and to use anti-thymocyte globulin as an induction agent compared to groups A and B. Significantly more patients in group C had positive flow cytometric crossmatch and had a higher incidence of preformed donor -specific antibody (DSA) compared to groups A and B. During follow-up, group C had a significantly higher rate of AMR, but the overall survival rate was comparable to that of groups A and B. In a subgroup analysis of group C, post -transplant survival was comparable despite higher preformed DSA in a desensitized group compared to the non -desensitized group. Conclusions : Patients with cPRA >= 50% had significantly higher incidence of preformed DSA and lower freedom from AMR, but post-HTx survival rates were similar to those with cPRA <50%. Our findings suggest that sensitized patients can attain comparable post -transplant survival to non -sensitized patients when treated with optimal desensitization treatment and therapeutic intervention.
MoreTranslated text
Key words
Heart transplantation,Prognosis,Antibodies,Human leukocyte antigen
PDF
View via Publisher
AI Read Science
Must-Reading Tree
Example

Generate MRT to find the research sequence of this paper
Data Disclaimer
The page data are from open Internet sources, cooperative publishers and automatic analysis results through AI technology. We do not make any commitments and guarantees for the validity, accuracy, correctness, reliability, completeness and timeliness of the page data. If you have any questions, please contact us by email: report@aminer.cn
Chat Paper
Summary is being generated by the instructions you defined