{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T11:29:15Z","timestamp":1790508555081,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,10,15]],"date-time":"2017-10-15T00:00:00Z","timestamp":1508025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009664","name":"Sociedad Espa\u00f1ola de Cardiolog\u00eda","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The development of donor\u2010specific antibodies (<jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content>) to human leukocyte antigens (<jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>) has been associated with acute rejection and allograft failure after heart transplantation. Not all <jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content>, however, can fix complement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To determine the association between complement\u2010fixing <jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content> and heart transplant outcomes, we retrospectively analyzed results obtained using the C1q solid\u2010phase assay that specifically detects complement\u2010fixing <jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content> in parallel with the standard IgG assay in 121 adult heart transplant recipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 52 recipients who developed post\u2010transplant <jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content> had a higher incidence of acute cellular rejection (58% vs 19%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and antibody\u2010mediated rejection (29% vs 7%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) than the 69 recipients without <jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content>. The 24 recipients with C1q+ <jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content> had more antibody\u2010mediated rejection than the 28 recipients with C1q\u2212 <jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content> (46% vs 14%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.012), but there was no difference in the incidence of acute cellular rejection between these two groups. Patients with post\u2010transplant <jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content> had higher mortality than patients with no <jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content> (29% vs 13%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.031), mainly due to increased incidence of acute rejection. No differences in survival were found between recipients with C1q+ <jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content> and C1q\u2212 <jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Routine monitoring of <jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content> post\u2010transplant, and their characterization using the C1q assay, may provide prognostic information for acute rejection after heart transplantation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.13121","type":"journal-article","created":{"date-parts":[[2017,9,22]],"date-time":"2017-09-22T08:38:45Z","timestamp":1506069525000},"source":"Crossref","is-referenced-by-count":23,"title":["The role of complement\u2010fixing donor\u2010specific antibodies identified by a C1q assay after heart 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Medicine Stanford University Medical Center  Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Valantine","sequence":"additional","affiliation":[{"name":"Laboratory of Transplantation Genomics National Institutes of Health  Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Khush","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Department of Medicine Stanford University Medical Center  Palo Alto CA 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