Preformed anti-human leukocyte antigen antibodies jeopardize cardiac transplantation in patients with a left ventricular assist device

Document Type

Article

Publication Date

3-2002

Publication Title

Heart & Lung: The Journal of Acute and Critical Care

Volume

31

Issue

2

First page number:

122

Last page number:

132

Abstract

In 1997, 15% of patients who received a cardiac transplant in the United States needed a mechanical circulatory support device before transplantation. One device that patients received was the left ventricular assist device (LVAD). During the LVAD support period, approximately 30% to 80% of LVAD recipients have positive test results for panel reactive antibodies (PRAs). Many of these antibodies form against human leukocyte antigens (HLA). These antigens are present on most cells and stimulate antibody production when a person receives unrelated donor cells. Several pre-LVAD and post-LVAD factors contribute to anti-HLA antibody formation. These antibody levels must be lowered before transplantation because the presence of anti-HLA antibodies makes it more difficult to find a suitable donor and increases the risk of rejection. The objectives of this article are to describe anti-HLA antibody formation in LVAD recipients, review its major consequences and treatments, and discuss nursing actions associated with anti-HLA antibody formation.

Keywords

Autoantibodies/analysis; Cardiomyopathy; Dilated/diagnosis; Cardiomyopathy; Dilated/immunology; Cardiomyopathy; Dilated/surgery; Cardiomyopathy; Dilated/therapy; Cardiovascular instruments; Implanted; Coronary Care Units; Fatal Outcome; Graft Rejection; Heart – Transplantation; HLA Antigens/analysis; HLA Antigens/immunology; HLA histocompatibility antigens; Heart Transplantation; Heart-Assist Devices; Histocompatibility Testing; Humans; Immunoglobulins; Male; Middle Aged; Myocardium – Diseases; Risk Assessment; Severity of Illness Index; Transplantation Immunology; Ventricular Dysfunction; Left/diagnosis; Ventricular Dysfunction; Left/therapy

Disciplines

Cardiology | Medicine and Health Sciences | Nursing

Language

English

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