Left ventricular assist system recipients exposed to bovine thrombin preparations have a higher frequency of antiphospholipid antibodies than nonexposed recipients.
After left ventricular assist system (LVAS) placement, recipients often develop antiphospholipid antibodies (aPL) that are associated with thrombosis. Fibrin glue containing a bovine thrombin preparation is used routinely in LVAS placement surgery. We investigated whether exposure to the thrombin preparation is responsible for stimulating aPL development in LVAS recipients. Pre-LVAS and weekly post-LVAS sera from six fibrin glue-exposed LVAS recipients and five nonexposed recipients were tested by enzyme-linked immunosorbent assay for IgG, IgA, and IgM anti-phosphatidylserine (aPS), anticardiolipin (aCL), anti-phosphatidylethanolamine (aPE), and anti-phosphatidylcholine (aPC). Fibrin glue exposed recipients developed a significantly greater number of aPL than the nonexposed recipients (24 vs. 8; p = 0.0069). In particular, a higher frequency of IgG aCL (6/6 vs. 1/5; p = 0.015) and IgG aPE (4/6 vs. 0/5; p = 0.045) were noted. Exposure to the bovine thrombin component of fibrin glue seems to stimulate aPL development in LVAS recipients.
Fastenau
D R
DR
Center for Reproduction and Transplantation Immunology, Methodist Hospital of Indiana, Indianapolis, USA.
Wagenknecht
D R
DR
Hormuth
D A
DA
McIntyre
J A
JA
D000328:Adult; D000818:Animals; D017153:Antibodies, Anticardiolipin / Q000097:blood; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D016022:Case-Control Studies; D002417:Cattle; D015718:Fibrin Tissue Adhesive / Q000009:adverse effects; 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; D010713:Phosphatidylcholines / Q000276:immunology; D010714:Phosphatidylethanolamines / Q000276:immunology; D010718:Phosphatidylserines / Q000276:immunology; D013917:Thrombin / Q000009:adverse effects*
D017153:Antibodies, Anticardiolipin; D017152:Antibodies, Antiphospholipid; D015718:Fibrin Tissue Adhesive; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D010713:Phosphatidylcholines; D010714:Phosphatidylethanolamines; D010718:Phosphatidylserines; D013917:Thrombin