Increased incidence of antiphospholipid antibodies in left ventricular assist system recipients.
BACKGROUND
Antiphospholipid antibodies are associated with thrombosis. Because thromboembolic complications are often observed in recipients of a left ventricular assist system, we questioned if antiphospholipid antibodies were present in these patients. We report results from 10 patients who received a Novacor left ventricular assist system.


METHODS
Serum samples were collected before left ventricular assist system placement and weekly thereafter until discharge after cardiac transplantation. Samples were tested for IgG, IgA, and IgM antiphosphatidylserine, anticardiolipin, and antiphosphatidylethanolamine using an enzyme-linked immunosorbent assay.


RESULTS
Development of phospholipid-binding plasma protein-dependent antiphospholipid antibodies was observed in 9 of the 10 patients. Before placement of the assist system, 3 patients had IgG antiphospholipid antibodies, and 9 were positive after placement. None had IgA antiphospholipid antibodies before placement, whereas 5 seroconverted for IgA after placement. One patient had IgM antiphospholipid antibodies before placement, and 1 additional patient became positive after placement. In patients with a preexisting antibody, increased titers and additional specificities developed subsequent to placement.


CONCLUSIONS
All but 1 patient showed development of phospholipid-binding plasma protein-dependent antiphospholipid antibodies after left ventricular assist system placement.
Center for Reproduction and Transplantation Immunology, Methodist Hospital, Indianapolis, Indiana 46202, USA.
D R
DR
Fastenau
D R
DR
Wagenknecht
J A
JA
McIntyre
D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D000925:Anticoagulants / Q000008:administration & dosage; D001798:Blood Proteins / Q000378:metabolism; D002308:Cardiolipins / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000009:adverse effects; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D010714:Phosphatidylethanolamines / Q000276:immunology; D010718:Phosphatidylserines / Q000276:immunology; D010743:Phospholipids / Q000097:blood; D011485:Protein Binding; D013923:Thromboembolism / Q000209:etiology / Q000276:immunology
D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants; D001798:Blood Proteins; D002308:Cardiolipins; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D010714:Phosphatidylethanolamines; D010718:Phosphatidylserines; D010743:Phospholipids