부산대학교 도서관

Background: Cardiac allograft vasculopathy (CAV) causes late graft dysfunction and post‐transplant mortality. Currently, the effects of different donor‐specific antibodies (DSA) on the severity of CAV remain unclear. Method: We evaluated 526 adult heart transplant recipients at a single center between January 2010 and August 2015. Subjects were divided into those with DSA (n = 142) and those without DSA (n = 384, control). The DSA group was stratified into persistent DSA (n = 34), transient DSA (n = 105), 1:8 dilution DSA (n = 45), complement‐binding (C1q) DSA (n = 36), Class I DSA (n = 37), and Class II DSA (n = 105). The primary outcome was the incidence of moderate‐to‐severe CAV (CAV 2/3) at 5‐year follow‐up. Results: Subjects with persistent DSA, 1:8 dilution DSA, and C1q DSA had higher incidence of CAV 2/3 compared the control group (17.6%, 13.3%, and 16.7% vs. 3.1%, respectively; P≤.001). The incidence of CAV 2/3 between subjects with transient DSA and the control group was similar (2.8% vs. 3.1%; P =.888). Subjects with Class II DSA also had higher incidence of CAV 2/3 (7.6% vs. 3.1%; P =.039). Conclusion: DSA that are persistent, 1:8 dilution positive, C1q positive, and Class II are associated with more severe grades of CAV. These DSA characteristics may prognosticate disease and warrant consideration for treatment. [ABSTRACT FROM AUTHOR]