title: Immunological and echocardiographic evaluation of decellularized versus cryopreserved allografts during the Ross operation.
abstract: OBJECTIVE
  Compare the immunological and echocardiographic data of decellularized versus cryopreserved allografts used for RVOT reconstruction during Ross operation.
  
  
  METHODS
  From 16/01/03 thru 07/10/03, 20 Ross operations were performed using decellularized (n=11) or cryopreserved (n=9) allografts. Echocardiography was done at discharge, 1, 3, 6 and 12 months and annually thereafter. Samples for determination of antibodies against HLA class I and II were obtained preoperatively and at days 5, 10, 30, 90 and 180 postoperatively. These samples were tested by the ELISA method in LAT-M dishes (unspecific) for identification of circulating antibodies and the results expressed as mean sample values (Is=DO/cutoff). If positive, LAT-E (specific) was performed and PRA levels determined.
  
  
  RESULTS
  There was no mortality. Cryopreserved allografts showed marked Is values elevations for class I and II antibodies which started at the first month and remained elevated up to 6 months. In contrast, of the patients receiving decellularized allografts, seven remained negative, two patients had only marginal elevation of class I antibodies and two patients showed abnormal elevations of PRA levels. This response happened earlier than in the cryopreserved group, starting on the 5th postoperative day and has returned to baseline levels in one case. Echocardiography showed mild, but significant, elevation of gradients in cryopreserved valves but none in the decellularized.
  
  
  CONCLUSIONS
  Decellularized allografts had normal function up to 18 months and showed important reduction of the immunogenic response when compared to cryopreserved valves.
authors.affiliation: Santa Casa de Curitiba-PUCPr, Curitiba, paraná, Brazil. fcosta@mps.com.br
authors.forename: Francisco Diniz Affonso
authors.initials: FD
authors.lastname: da Costa
authors.forename: Pascal Maria
authors.initials: PM
authors.lastname: Dohmen
authors.forename: Daniele
authors.initials: D
authors.lastname: Duarte
authors.forename: Cristina
authors.initials: C
authors.lastname: von Glenn
authors.forename: Sérgio Veiga
authors.initials: SV
authors.lastname: Lopes
authors.forename: Hermínio Haggi
authors.initials: HH
authors.lastname: Filho
authors.forename: Marise Brenner Affonso
authors.initials: MB
authors.lastname: da Costa
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Konertz
mesh_terms: D000293:Adolescent; D000328:Adult; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000502:physiology / Q000601:surgery*; D001705:Bioprosthesis; D002648:Child; D015925:Cryopreservation; D005260:Female; D006680:HLA Antigens / Q000276:immunology; D006349:Heart Valve Diseases / Q000503:physiopathology / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D007518:Isoantibodies / Q000096:biosynthesis; D008297:Male; D011184:Postoperative Period; D011664:Pulmonary Valve / Q000276:immunology / Q000473:pathology / Q000637:transplantation; D014463:Ultrasonography; D014694:Ventricular Outflow Obstruction / Q000601:surgery
chemical_list: D006680:HLA Antigens; D007518:Isoantibodies