Background
The presence of pre-formed IgA anti–β2-glycoprotein I antibodies (IgA-aB2GP1ab) has been related to early graft loss after
kidney transplant. Because β2-glycoprotein I is produced in both the kidney and heart, we aimed to assess whether
the presence of these antibodies may also be associated with poor outcomes after heart
transplantation (HT).
Methods
A 2-year follow-up retrospective analysis of 151 consecutive patients who underwent
HT between 2004 and 2012 was performed to assess the role of this pre-formed antibody
type in HT. The population was divided into 2 groups according to the presence of
IgA: Group 1 was positive for IgA-aB2GP1ab (47 patients, 31.1%), and Group 2 was negative
for IgA-Ab2GP1ab (104 patients, 68.9%).
Results
Early mortality rates within the first 3 months were higher in Group 1 (27.7%) than
in Group 2 (9.6%). No differences in donor and recipient characteristics or in causes
of death were observed between groups. Multivariate analysis identified the presence
of IgA-aB2GP1ab, female gender and blood type A as independent risks factors for early
mortality after HT. A greater incidence of thrombotic events during the first 3 months
post-HT in Group 1 (23.4% vs 5.8%) and a greater presence of risk factors for thrombotic
events, which may have exacerbated them, were observed. After this period, no increase
in mortality or in thrombotic events was found when the 2 groups were compared.
Conclusion
Pre-transplant presence of IgA-aB2GP1ab is associated with both increased early mortality
rates and higher thrombotic events after HT.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The Journal of Heart and Lung TransplantationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The Registry of the International Society for Heart and Lung Transplantation: thirty-second official adult lung and heart–lung transplantation report—2015; Focus theme: Early graft failure.J Heart Lung Transplant. 2015; 34: 1264-1277
- Interactions among donor characteristics influence post-transplant survival: a multi-institutional analysis.J Heart Lung Transplant. 2010; 29: 291-298
- Association of early kidney allograft failure with preformed IgA antibodies to beta2-glycoprotein I.J Am Soc Nephrol. 2015; 26: 735-745
- Primary graft failure after heart transplantation: characteristics in a contemporary cohort and performance of the RADIAL risk score.J Heart Lung Transplant. 2013; 32: 1187-1195
- Report from a consensus conference on primary graft dysfunction after cardiac transplantation.J Heart Lung Transplant. 2014; 33: 327-340
- IgA anticardiolipin and IgA anti-beta2 glycoprotein I antibody positivity determined by fluorescence enzyme immunoassay in primary antiphospholipid syndrome.Clin Chem Lab Med. 2014; 52: 1329-1333
- International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS).J Thromb Haemost. 2006; 4: 295-306
- Diagnosis and classification of the antiphospholipid syndrome.J Autoimmun. 2014; 48-49: 20-25
- The pathogenesis of the antiphospholipid syndrome.N Engl J Med. 2013; 368: 1033-1044
- RT-PCR and in situ hybridization analysis of apolipoprotein H expression in rat normal tissues.Int J Mol Med. 2006; 18: 449-455
- Pathogenesis of antiphospholipid syndrome: understanding the antibodies.Nat Rev Rheumatol. 2011; 7: 330-339
- International consensus guidelines on anticardiolipin and anti-beta2-glycoprotein I testing: report from the 13th International Congress on Antiphospholipid Antibodies.Arthritis Rheum. 2012; 64: 1-10
- Renal transplantation dramatically reduces IgA anti-beta-2-glycoprotein I antibodies in patients with endstage renal disease.J Immunol Res. 2014; 2014: 641962
- Primary, secondary, and catastrophic antiphospholipid syndrome: what’s in a name?.Semin Thromb Hemost. 2008; 34: 219-226
- The presence of pretransplant antiphospholipid antibodies IgA anti-beta-2-glycoprotein I as a predictor of graft thrombosis after renal transplantation.Transplantation. 2017; 101: 597-607
- [Predictive variables of early mortality after orthotopic heart transplant in adults].Rev Esp Cardiol. 1997; 50: 628-634
- ABO blood group as a potential risk factor for venous thromboembolism in acutely injured patients.Thromb Haemost. 2011; 105: 5-13
- Non-O blood type is the commonest genetic risk factor for VTE: results from a meta-analysis of the literature.Semin Thromb Hemost. 2012; 38: 535-548
- ABO blood group and risk of thromboembolic and arterial disease: a study of 1.5 million blood donors.Circulation. 2016; 133: 1449-1457
- Sex-based differences in cardiometabolic biomarkers.Circulation. 2017; 135: 544-555
- Insights from the NHLBI-Sponsored Women’s Ischemia Syndrome Evaluation (WISE) Study: Part II: Gender differences in presentation, diagnosis, and outcome with regard to gender-based pathophysiology of atherosclerosis and macrovascular and microvascular coronary disease.J Am Coll Cardiol. 2006; 47: S21-S29
Article info
Publication history
Published online: May 19, 2017
Identification
Copyright
© 2017 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
