{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T06:49:10Z","timestamp":1780642150658,"version":"3.54.1"},"reference-count":22,"publisher":"Hindawi Limited","license":[{"start":{"date-parts":[[2013,1,1]],"date-time":"2013-01-01T00:00:00Z","timestamp":1356998400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"funder":[{"name":"Banca del Monte Foundation"},{"name":"Transplant Program Funding of the region of Emilia Romagna"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Transplantation"],"published-print":{"date-parts":[[2013]]},"abstract":"<jats:p>HLA antibodies (HLA ab) in transplant candidates have been associated with poor outcome. However, clinical relevance of noncytotoxic antibodies after heart transplant (HT) is controversial. By using a Luminex-based HLA screening, we retested pretransplant sera from HT recipients testing negative for cytotoxic HLA ab and for prospective crossmatch. Out of the 173 consecutive patients assayed (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mn>52<\/mml:mn><mml:mo>\u00b1<\/mml:mo><mml:mn>13<\/mml:mn><mml:mi>y<\/mml:mi><\/mml:math>; 16% females; 47% ischemic etiology), 32 (18%) showed pretransplant HLA ab, and 12 (7%) tested positive against both class I and class II HLA. Recipients with any HLA ab had poorer survival than those without (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mn>65<\/mml:mn><mml:mo>\u00b1<\/mml:mo><mml:mn>9<\/mml:mn><\/mml:math>versus<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mn>82<\/mml:mn><mml:mo>\u00b1<\/mml:mo><mml:mn>3<\/mml:mn><\/mml:math>%;<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.02<\/mml:mn><\/mml:math>), accounting for a doubled independent mortality risk (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.04<\/mml:mn><\/mml:math>). In addition, HLA-ab detection was associated with increased prevalence of early graft failure (35 versus 15%;<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.05<\/mml:mn><\/mml:math>) and late cellular rejection (29 versus 11%;<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.03<\/mml:mn><\/mml:math>). Of the subgroup of 37 patients suspected for antibody mediated rejection (AMR), the 9 with pretransplant HLA ab were more likely to display pathological AMR grade 2 (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\"><mml:mi>P<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.04<\/mml:mn><\/mml:math>). By an inexpensive, luminex-based, HLA-screening assay, we were able to detect non-cytotoxic HLA ab predicting fatal and nonfatal adverse outcomes after heart transplant. Allocation strategies and desensitization protocols need to be developed and prospectively tested in these patients.<\/jats:p>","DOI":"10.1155\/2013\/519680","type":"journal-article","created":{"date-parts":[[2013,7,29]],"date-time":"2013-07-29T17:02:51Z","timestamp":1375117371000},"page":"1-6","source":"Crossref","is-referenced-by-count":14,"title":["Occurrence of Fatal and Nonfatal Adverse Outcomes after Heart Transplantation in Patients with Pretransplant Noncytotoxic HLA Antibodies"],"prefix":"10.1155","volume":"2013","author":[{"given":"Luciano","family":"Potena","sequence":"first","affiliation":[{"name":"Cardiovascular Department, Academic Hospital S. Orsola-Malpighi, University of Bologna, Building 21, Via Massarenti 9, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Bontadini","sequence":"additional","affiliation":[{"name":"Immunogenetics Unit, Transfusion Service, Academic Hospital S. Orsola-Malpighi, University of Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Iannelli","sequence":"additional","affiliation":[{"name":"Immunogenetics Unit, Transfusion Service, Academic Hospital S. Orsola-Malpighi, University of Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiorenza","family":"Fruet","sequence":"additional","affiliation":[{"name":"Immunogenetics Unit, Transfusion Service, Academic Hospital S. Orsola-Malpighi, University of Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ornella","family":"Leone","sequence":"additional","affiliation":[{"name":"Pathology Department, Academic Hospital S. Orsola-Malpighi, University of Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Barberini","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Academic Hospital S. Orsola-Malpighi, University of Bologna, Building 21, Via Massarenti 9, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Borgese","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Academic Hospital S. Orsola-Malpighi, University of Bologna, Building 21, Via Massarenti 9, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Manfredini","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Academic Hospital S. Orsola-Malpighi, University of Bologna, Building 21, Via Massarenti 9, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Masetti","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Academic Hospital S. Orsola-Malpighi, University of Bologna, Building 21, Via Massarenti 9, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaia","family":"Magnani","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Academic Hospital S. Orsola-Malpighi, University of Bologna, Building 21, Via Massarenti 9, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Fallani","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Academic Hospital S. Orsola-Malpighi, University of Bologna, Building 21, Via Massarenti 9, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Grigioni","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Academic Hospital S. 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