Factors Related to the Acute Cellular Rejection During the First Year After Heart Transplant

2018 ◽  
Vol 50 (10) ◽  
pp. 3715-3719
Author(s):  
E. Toro-Trujillo ◽  
E. Garcia ◽  
A.A. Garcia-Peña ◽  
O.M. Muñoz-Velandia ◽  
A. Mariño
Keyword(s):  
Heart Transplant ◽  
Acute Cellular Rejection ◽  
First Year ◽  
Cellular Rejection

scholarly journals P354 Right heart catheterization parameters, echocardiography parameters and B-Type natriuretic peptide prediction of acute cellular rejection in the first year after heart transplant

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A A Valentim Goncalves ◽  
T Pereira-Da-Silva ◽  
R Soares ◽  
R Ilhao Moreira ◽  
L De Sousa ◽  
...  
Keyword(s):  
Natriuretic Peptide ◽  
Heart Transplant ◽  
Right Heart Catheterization ◽  
Acute Cellular Rejection ◽  
Atrial Pressure ◽  
Right Atrial ◽  
Heart Catheterization ◽  
First Year ◽  
Right Heart ◽  
Cellular Rejection

Abstract Introduction Since the mid-1970s, the diagnosis of acute cellular rejection (ACR) has been made by endomyocardial biopsy (EMB). Whether B-Type Natriuretic Peptide (BNP), transthoracic echocardiography (TTE) parameters and right heart catheterization (RHC) parameters can detect rejection in heart transplant (HT) patients have yielded conflicting results and did not overcome the use of EMB in the first year after HT. Purpose The aim of this study was to evaluate whether BNP, TTE and RHC parameters can be used to detect ACR in the first year after HT. Methods Prospective study of consecutive EMB performed in the first year after HT. Plasma BNP levels, TTE and RHC were performed at the same day. Clinical significant ACR was defined as ≥ 2R, according to the ISHLT 2004 grading. The area under the curve (AUC) was analysed for statistically significant associations to detect ACR. Results From 2017 to 2018, 50 EMB were performed with the following results: 2R - 5 (10.0%); 1R- 29 (58.0%); 0 – 16 (32%). Mean age was 48.7 ± 8.3 years, with mean BNP value of 964.4 ± 1114.7pg/ml. AUC results of BNP and several TTE and RHC parameters for the prediction of ACR are represented in the table. Right atrial pressure (RAP) value (p = 0.027) was the only significantly predictor of ACR, while isovolumic relaxation time measured by TTE revealed a borderline significant trend (p = 0.076). RAP > 10mmHg had a sensitivity of 60.0% and a specificity of 84.4% for detecting ACR. Conclusion Detecting ACR without EMB remains a clinical challenge, but RAP measured by RHC was a significant predictor of ACR in the first year after HT, while BNP values did not correlate with ACR. AUC values PARAMETERS AUC p 95% CI BNP 0.658 0.251 0.405-0.911 Troponin I 0.591 0.507 0.260-0.923 Left ventricular ejection fraction 0.416 0.541 0.218-0.614 E/A 0.480 0.895 0.282-0.678 Deceleration time 0.463 0.463 0.161-0.765 Isovolumic relaxion time 0.745 0.076 0.427-1.000 Cardiac index 0.595 0.488 0.346-0.845 Pulmonary capillary wedge pressure 0.628 0.401 0.329-0.926 Mean pulmonary artery pressure 0.684 0.181 0.511-0.857 Right atrial pressure 0.804 0.027 0.631-0.978 AUC values

Abstract 2099: Pretransplant Toxoplasma Gondii Seropositivity Amongst Heart Transplant Recipients Is Associated With An Increased Risk Of All-cause And Cardiac Mortality

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Satish Arora ◽  
Pål Jenum ◽  
Pål Aukrust ◽  
Halvor Rollag ◽  
Arne Andreassen ◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
Heart Transplant ◽  
Acute Cellular Rejection ◽  
Serum Samples ◽  
Regulatory Changes ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Cellular Rejection

Chronic Toxoplasma gondii (T. gondii ) infection is known to trigger potentially adverse immuno-regulatory changes, but the long-term implication for heart transplant (HTx) recipients has not been assessed previously. Hence, we evaluated the risk of mortality, development of cardiac allograft vasculopathy (CAV) and acute cellular rejection amongst T. gondii seropositive HTx recipients and the four donor/recipient seropairing groups. Methods: Frozen pre-HTx serum samples of 288 recipients and 246 donors were evaluated for T. gondii serostatus using Platelia IgG immunoassay method. All patients had also undergone prospective serostatus evaluation using alternative assays and results determined by the two methods were compared. Follow-up data regarding mortality, CAV development and acute cellular rejection was available for all patients. Results: Overall, 211 (73%) recipients were seronegative and 77 (27%) were seropositive. In total, 82 recipients died, 76 developed CAV and 82 had significant cellular rejection. Recipient seropositivity was associated with a significantly higher risk of all-cause mortality (hazard ratio [HR], 1.9; 95% CI, 1.1–3.4; p= 0.02) and CAV mortality (HR=4.4; 95% CI, 1.3–15.6, p=0.02), but was not associated with earlier CAV development or higher rejection score. Donor/recipient seropairing status was not a risk factor for any endpoint. Conclusions: T. gondii seropositivity amongst HTx recipients is associated with a significantly increased risk of long-term total, and in particular CAV-related, mortality. This may be mediated via immunoregulatory changes triggered by chronic T. gondii infection and needs to be explored further.

Myocardial HLA-G Reliably Indicates a Low Risk of Acute Cellular Rejection in Heart Transplant Recipients

2008 ◽  
Vol 27 (5) ◽  
pp. 522-527 ◽  
Author(s):  
Rohit Sheshgiri ◽  
Nathalie Rouas-Freiss ◽  
Vivek Rao ◽  
Jagdish Butany ◽  
Danny Ramzy ◽  
...  
Keyword(s):  
Heart Transplant ◽  
Acute Cellular Rejection ◽  
Low Risk ◽  
Transplant Recipients ◽  
Heart Transplant Recipients ◽  
Cellular Rejection
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