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THE CORRELATION BETWEEN CLINICAL AND ECHOCARDIOGRAPHIC OUTCOME WITH PRESENCE OF THE HLA ANTIBODIES IN CELLULAR AND DECELLULARIZED CRYOPRESERVED HUMAN HEART VALVE ALLOGRAFTS.
Daniela Contini-Duarte, Carolina Kneib, Karina Omairi, Ivy N. Vieira, Vanessa S. Paladino, Marco A. Costa, Sandra M. Ferreira, Joao Gabriel R. Mendon
a, Marise B. Costa, Claudinei Colatusso, Sergio A.V. Lopes, Pascal Dohmen, MD, Wolfgang Kornetz, MD, Francisco D.A. Costa, MD and Cristina Q.C. von Glehn, MSc. Curitiba Parana, Brazil, Cajuru University Hospital/Health Alliance/PUCPR, 80050-350, Immunogenetics Laboratory; Curitiba Parana, Brazil, Health Alliance/PUCPR, 80000-000, Homograft Tissue Bank; Curitiba Parana, Brazil, Health Alliance / PUCPR, 80000-000, Cardiac Surgery and Berlin Germany, School of Medicine / Humbolt University, 10117, Cardiovascular Surgery.
Studies have showed that cellular and decellularized cryiopreserved allograft have less antigenic than “fresh” valves. The purpose of this study was to correlate the presence of the HLA antibodies with the flow blood in valves allografts. Sera samples (pre and 5, 10, 30 , 90 and 180 PO days) were took from 14 patients: 6 (Group A) received cellular allograft, 8 (Group B) received decellularized allograft. The sera were assayed for anti HLA antibody by ELISA test. The patients had been submitted to echocardiography in the 1st, 2nd, 3rd, 6th and 12th months. None of them died during the observation time. In the group A all patient became positive to HLA classes I and II antibodies after 30th PO. In the group B only 3 patients became positive only for HLA class I and became negative again in the 90th PO. All patients had a good outcome. The blood flow was stable at 1 year, varying between 2 for 14 mmHg. Both cellular and decellularized allografts were immunogenic. They determine different humoral response to HLA antigens, but echocardiographic analyses did not demonstrate correlation between the antibodies and blood flow alterations in the first year of implantation.