Late rejection occurred in recipients who experienced acute cellular rejection within the first year after heart transplantation

Teruhiko Imamura, Koichiro Kinugawa, Daisuke Nitta, Takeo Fujino, Toshiro Inaba, Hisataka Maki, Masaru Hatano, Osamu Kinoshita, Kan Nawata, Atsushi Yao, Shunei Kyo, Minoru Ono

研究成果: ジャーナルへの寄稿学術誌査読

6 被引用数 (Scopus)

抄録

Serial endomyocardial biopsies (EMBs) are scheduled even several years after heart transplantation (HTx) to monitor for late rejection (LR). However, repeated EMBs are associated with an increased risk for fatal complications and decrease the quality of life of the recipient. We retrospectively analyzed clinical data from 42 adult recipients who had received HTx and were followed > 1 year at the University of Tokyo Hospital. Five recipients experienced LR at 1130 ± 157 days after HTx, and all 5 had experienced acute cellular rejection (ACR) with ISHLT grade ≥ 2R within the first year, which was treated with methylprednisolone pulse therapy (sensitivity, 1.000; specificity, 0.7027). Logistic regression analyses demonstrated that positive panel reactive antibody (PRA) was the only significant predictor for LR among all parameters at 1 year after HTx (P = 0.020, odds ratio 24.00). Among the 5 recipients with LR, LR occurred earlier in the two PRA positive recipients than in those with a negative PRA (981 ± 12 versus 1230 ± 110 days, P = 0.042). Among the perioperative parameters, gender mismatch [n = 13 (31%)] was the only significant predictor for ACR within the first year in logistic regression analyses (P = 0.042, odds ratio 4.200). In conclusion, the current schedule of serial EMBs should perhaps be reconsidered for recipients without any history of ACR within the first year due to their lower risk of LR.

本文言語英語
ページ(範囲)174-179
ページ数6
ジャーナルInternational heart journal
56
2
DOI
出版ステータス出版済み - 2月 23 2015
外部発表はい

!!!All Science Journal Classification (ASJC) codes

  • 循環器および心血管医学

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