title: Immune response following fresh arterial homograft replacement for aortoiliac graft infection.
abstract: BACKGROUND
  this prospective study defines the immune response to fresh arterial homograft replacement for graft infection.
  
  
  METHODS
  ten patients who underwent ABO-compatible homograft transplantation were studied for anti-HLA antibody production, and CD3-CD4-CD8-positive lymphocytes subset. Immunological studies were performed preoperatively, and at early (1, 3, 7 days) and late (1, 3, 6, 12, 18, 24 months) follow-up. All patients received immunosuppressive treatment with cyclosporine (1-3 mg/kg/day). Abdominal CT scans were performed postoperatively at the 1, 6, 12, 18, 24 months follow-up.
  
  
  RESULTS
  preoperatively, antibodies could not be detected. Postoperatively, as from 1st month post-transplant, a progressive increase in % PRA was observed in all patients, up to the 12th month of follow-up. Subsequently, at 18 and 36 months, a progressive decrease in % PRA was detected. Data showed that the recipient antibodies were directed against donor-specific antigens. During the immediate postoperative period (1, 3, 7 days) CD3- and CD4-positive T lymphocytes slightly increased, whereas CD8 simultaneously decreased. Later, CD3 and CD4 progressively decreased and CD8 increased. Clinically, all patients were cured of infection at late follow-up. CT scans showed thickening of the aortic wall (range: 2.5-4.5 mm), with no signs of aneurysmal degeneration.
  
  
  CONCLUSIONS
  fresh arterial homografts are immunogenic. Implanted homografts induce a strong anti-HLA antibody response, similar to chronic rejection, in spite of immunosuppressive treatment.
authors.affiliation: Department of Vascular Surgery, S. Orsola Hospital, Bologna, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Mirelli
authors.forename: A
authors.initials: A
authors.lastname: Stella
authors.forename: G L
authors.initials: GL
authors.lastname: Faggioli
authors.forename: M P
authors.initials: MP
authors.lastname: Scolari
authors.forename: S
authors.initials: S
authors.lastname: Iannelli
authors.forename: A
authors.initials: A
authors.lastname: Freyrie
authors.forename: A
authors.initials: A
authors.lastname: Buscaroli
authors.forename: L
authors.initials: L
authors.lastname: De Santis
authors.forename: F
authors.initials: F
authors.lastname: Resta
authors.forename: V
authors.initials: V
authors.lastname: Bonomini
authors.forename: M
authors.initials: M
authors.lastname: D'Addato
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology; D000368:Aged; D000918:Antibody Specificity / Q000276:immunology; D001012:Aorta, Abdominal / Q000601:surgery*; D001158:Arteries / Q000276:immunology / Q000637:transplantation*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D017252:CD3 Complex / Q000276:immunology; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D005263:Femoral Artery / Q000601:surgery; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000276:immunology* / Q000601:surgery; D012086:Reoperation; D013997:Time Factors; D014181:Transplantation Immunology / Q000276:immunology; D014184:Transplantation, Homologous
chemical_list: D000017:ABO Blood-Group System; D017252:CD3 Complex; D006680:HLA Antigens