Non-specific removal of antibodies in patients with idiopathic dilated cardiomyopathy: implications for xenotransplantation.
We assessed the efficiency of non-specific extracorporeal immunoadsorption (EIA), using polyclonal anti-human immunoglobulin antibodies, in depleting the serum of anti-galactosealpha1,3galactose (Gal) antibody and in decreasing serum cytotoxicity in 5 patients with idiopathic dilated cardiomyopathy. The mean concentrations of anti-Gal immunoglobulin (Ig)M and IgG before EIA were 74 microg/ml and 159 microg/ml, respectively. After EIA, these concentrations decreased by 86% and 88%, respectively. Both anti-Gal IgM and IgG returned to pre-EIA concentrations within 1 month, without rebound to greater than baseline concentrations. After EIA, mean serum cytotoxicity also decreased from 90% to 17%, with recovery by 1 month. Extracorporeal immunoadsorption proved safe in patients with heart failure and was effective in depleting anti-Gal antibody and in decreasing serum cytotoxicity to pig cells.
Knosalla
Christoph
C
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany.
Müller
Johannes
J
Moran
Kathleen
K
Wallukat
Gerd
G
Hetzer
Roland
R
Cooper
David K C
DK
D000328:Adult; D000818:Animals; D000888:Antibodies, Anti-Idiotypic; D001323:Autoantibodies / Q000097:blood*; D002311:Cardiomyopathy, Dilated / Q000276:immunology* / Q000601:surgery; D004187:Disaccharides / Q000276:immunology*; D006321:Heart; D016027:Heart Transplantation; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D007075:Immunoglobulin M / Q000097:blood*; D007163:Immunosorbent Techniques; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000276:immunology; D013552:Swine; D014183:Transplantation, Heterologous
D000888:Antibodies, Anti-Idiotypic; D001323:Autoantibodies; D004187:Disaccharides; D007074:Immunoglobulin G; D007075:Immunoglobulin M; C055075:galactosyl-(1-3)galactose