{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:34:31Z","timestamp":1788348871978,"version":"build-2803163510"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1998,8,25]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            \u2014Preformed anti-HLA antibodies reacting specifically with donor lymphocytes have been associated with acute vascular rejection and early cardiac allograft failure. However, the effect of preformed anti-HLA antibodies directed against allogeneic major histocompatibility complex (MHC) class I or II antigens of a donor panel on heart transplantation outcome has not been extensively studied.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods and Results<\/jats:italic>\n            \u2014The study group consisted of 68 patients who received cardiac transplants between 1989 and 1996 and who were at high risk for developing anti-HLA antibodies before transplantation. The effect of preformed antibodies against allogeneic MHC class I or class II antigens on the development of early high-grade cellular rejection and on cumulative annual rejection frequency was determined. Both patients with left ventricular assist devices and retransplantation candidates had a similar increase in the frequency of IgG anti-MHC class II antibodies (IgG anti-II) compared with control subjects (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.0001), whereas the frequency of IgG anti-MHC class I antibodies (IgG anti-I) was elevated only in patients with left ventricular assist devices. Pretransplantation IgG anti-II predicted early development of high-grade cellular rejection (\n            <jats:italic>P<\/jats:italic>\n            =0.006) and higher cumulative annual rejection frequency (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.001) in both of these sensitized patient groups. Among retransplantation recipients, a match between donors 1 and 2 at HLA-A additionally predicted an earlier time to a high-grade cellular rejection.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014These results emphasize the importance of specifically screening heart transplantation candidates for the presence of IgG antibodies directed against MHC class II molecules and suggest that strategies aimed at their reduction may have an impact on the onset and frequency of high-grade cellular rejections after transplantation.\n          <\/jats:p>","DOI":"10.1161\/01.cir.98.8.786","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:41:02Z","timestamp":1339461662000},"page":"786-793","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":133,"title":["Preformed IgG Antibodies Against Major Histocompatibility Complex Class II Antigens Are Major Risk Factors for High-grade Cellular Rejection in Recipients of Heart Transplantation"],"prefix":"10.1161","volume":"98","author":[{"given":"Silviu","family":"Itescu","sequence":"first","affiliation":[{"name":"From the Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas C.","family":"Tung","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth M.","family":"Burke","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Weinberg","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nader","family":"Moazami","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John H.","family":"Artrip","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Suciu-Foca","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric A.","family":"Rose","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet C.","family":"Oz","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Michler","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/0966-3274(93)90060-L"},{"key":"e_1_3_1_2_2","first-page":"272","volume":"50","year":"1993","unstructured":"Joysey VC. Tissue typing, heart and heart-lung transplantation. Br J Biomed Sci. 1993;50:272\u2013276.","journal-title":"Br J Biomed Sci"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199210000-00017"},{"key":"e_1_3_1_4_2","first-page":"921","volume":"10","year":"1991","unstructured":"Lavee J, Kormos RL, Duquesnoy RJ, Zerbe TR, Armitage JM, Vanek M, Hardesty RL, Griffith BP. Influence of panel-reactive antibody and lymphocytotoxic cross-match on survival after heart transplantation. J Heart Lung Transplant. 1991;10:921\u2013930.","journal-title":"J Heart Lung Transplant"},{"key":"e_1_3_1_5_2","first-page":"194","volume":"13","year":"1994","unstructured":"Loh E, Bergin JD, Couper GS, Mudge GH. Role of panel-reactive antibody cross-reactivity in predicting survival after orthotopic heart transplantation. J Heart Lung Transplant. 1994;13:194\u2013201.","journal-title":"J Heart Lung Transplant"},{"key":"e_1_3_1_6_2","first-page":"94","volume":"68","year":"1983","unstructured":"Hess ML, Hastillo A, Mohanakumar T, Cowley MJ, Vetrovac G, Szentpetery S, Wolfgang TC, Lower RR. Accelerated atherosclerosis in cardiac transplantation: role of cytotoxic B-cell antibodies and hyperlipidemia. Circulation. 1983;68:94\u2013101.","journal-title":"Circulation"},{"key":"e_1_3_1_7_2","first-page":"203","volume":"106","year":"1989","unstructured":"Rose EA, Smith CR, Petrossian GA, Barr ML, Reemtsma K. Humoral immune responses after cardiac transplantation: correlation with fatal rejection and graft atherosclerosis. Surgery. 1989;106:203\u2013208.","journal-title":"Surgery"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199103000-00033"},{"key":"e_1_3_1_9_2","first-page":"856","volume":"14","year":"1995","unstructured":"George JF, Kirklin JK, Shroyer DC, Naftel DC, Bourge RC, McGiffin DC, White-Williams C, Noreuil T. Utility of post-transplantation panel-reactive antibody measurements for the prediction of rejection frequency and survival of heart transplant recipients. J Heart Lung Transplant. 1995;14:856\u2013861.","journal-title":"J Heart Lung Transplant"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(96)70141-1"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1958.10501452"},{"key":"e_1_3_1_12_2","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/j.2517-6161.1972.tb00899.x","volume":"34","year":"1972","unstructured":"Cox DR. Regression models and life tables (with discussion). J R Stat Soc. 1972;34:187\u2013220.","journal-title":"J R Stat Soc"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1989.10478873"},{"key":"e_1_3_1_14_2","first-page":"S104","volume":"11","year":"1992","unstructured":"Zerbe T, Uretsky B, Kormos R, Armitage J, Wolyn T, Griffith B, Hardesty R, Duquesnoy R. Graft atherosclerosis: effects of cellular rejection and human lymphocyte antigen. J Heart Lung Transplant. 1992;11:S104\u2013S110.","journal-title":"J Heart Lung Transplant"},{"key":"e_1_3_1_15_2","first-page":"S90","volume":"11","year":"1992","unstructured":"Constanzo-Nordin MR. Cardiac allograft vasculopathy: relationship with acute cellular rejection and histocompatibility. J Heart Lung Transplant. 1992;11:S90\u2013S103.","journal-title":"J Heart Lung Transplant"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI118898"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199709270-00009"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI1117"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0952-7915(96)80012-4"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/0167-5699(93)90274-O"},{"key":"e_1_3_1_21_2","first-page":"556","volume":"61","year":"1996","unstructured":"Reed EF, Hong B, Ho E, Harris PE, Weinberger J, Suciu-Foca N. Monitoring of soluble HLA alloantigens and anti-HLA antibodies identifies heart allograft recipients at risk of transplant associated coronary artery disease. Transplantation. 1996;61:556\u2013572.","journal-title":"Transplantation"},{"key":"e_1_3_1_22_2","first-page":"A150","volume":"16","year":"1996","unstructured":"Itescu S, Burke EM, Weinberg AD, Tung T, Rose EA, Oz MC, Suciu-Foca N, Michler RE. B cell hyperreactivity in recipients of left ventricular assist devices (LVAD): association of HLA-DR3 with anti-HLA antibodies. J Heart Lung Transplant. 1996;16:A150. Abstract.","journal-title":"J Heart Lung Transplant"},{"key":"e_1_3_1_23_2","first-page":"746","volume":"11","year":"1992","unstructured":"Rose EA, Barr ML, Xu H, Pepino P, Murphy MP, McGovern MA, Ratner AJ, Watkins JF, Marboe CC, Berger CL. Photochemotherapy in human heart transplant recipients at high risk for fatal rejection. J Heart Lung Transplant. 1992;11:746\u2013750.","journal-title":"J Heart Lung Transplant"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199609150-00027"},{"key":"e_1_3_1_25_2","first-page":"2750","volume":"26","year":"1994","unstructured":"Hodge EE, Klingman LL, Koo AP, Nally J, Hobbs RE, Stewart RW, Cook DJ. Pretransplant removal of anti-HLA antibodies by plasmapheresis and continued suppression on cyclosporine-based therapy after heart-kidney transplant. Transplant Proc. 1994;26:2750\u20132751.","journal-title":"Transplant Proc"},{"key":"e_1_3_1_26_2","first-page":"1366","volume":"107","year":"1994","unstructured":"Ruiz JC, de Francisco AL, Vazquez de Prada JA, Ruano J, Pastor JM, Alcalde G, Arias M. Successful heart transplantation after anti-HLA antibody removal with protein-A immunoadsorption in a hyperimmunized patient. J Thorac Cardiovasc Surg. 1994;107:1366\u20131367.The influence of preformed anti-HLA antibodies on cellular rejection was studied in 68 heart transplantation recipients at risk for sensitization. IgG anti-MHC class II antibodies (IgG anti-II) were present at higher frequency among both left ventricular assist device and retransplantation recipients than in control subjects and were associated with early high-grade cellular rejection (P=0.006) and higher cumulative annual rejection frequency (P<0.001). Among retransplantation recipients, a donor 1\u2013donor 2 HLA-A match additionally predicted early cellular rejection. These results emphasize the importance of screening for IgG anti-II pretransplantation and suggest that strategies aimed at their reduction may improve heart transplantation outcome.","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.CIR.98.8.786","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T16:55:12Z","timestamp":1715532912000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.98.8.786"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,8,25]]},"references-count":26,"journal-issue":{"issue":"8","published-print":{"date-parts":[[1998,8,25]]}},"alternative-id":["10.1161\/01.CIR.98.8.786"],"URL":"https:\/\/doi.org\/10.1161\/01.cir.98.8.786","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[1998,8,25]]},"assertion":[{"value":"1997-12-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1998-04-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1998-08-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}