title: Two-year reduction of panel reactive human leukocyte antigen antibodies in children receiving mycophenolate mofetil after valved allograft placement.
abstract: Allografts used in the repair of congenital heart defects in children induce a persistent broad HLA antibody response. We have previously shown that a 3-month course of mycophenolic mofetil (MMF) significantly reduces the HLA class I antibody response to valved allograft implantation in children. The purpose of this study was to determine if this reduction in HLA antibody persists after discontinuation of MMF. We conducted follow-up (mean 2 +/- 0.5 years) of seven patients who had received allograft placement for repair of congenital heart defects. These patients received 3 months of immunosuppression with MMF following allograft implantation. When compared to historical controls, patients who received MMF following surgery showed a significantly decreased HLA class I antibody response at 2 years postimplantation. This study demonstrates the ability to persistently alter the HLA class I antibody response using 3 months of MMF following allograft implantation in children.
authors.affiliation: Department of Pediatrics, University of North Carolina School of Medicine, North Carolina Children's Hospital, Chapel Hill, NC, USA.
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Anderson
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Fuller
authors.forename: John A
authors.initials: JA
authors.lastname: Hawkins
authors.forename: Maureen K
authors.initials: MK
authors.lastname: Brinkman
authors.forename: Tracie
authors.initials: T
authors.lastname: Profaizer
authors.forename: Robert E
authors.initials: RE
authors.lastname: Shaddy
mesh_terms: D000293:Adolescent; D000906:Antibodies / Q000737:chemistry*; D000917:Antibody Formation; D002648:Child; D002675:Child, Preschool; D005434:Flow Cytometry; D019084:Fluorescent Antibody Technique, Indirect; D006084:Graft Rejection; D006680:HLA Antigens / Q000737:chemistry / Q000276:immunology*; D006330:Heart Defects, Congenital / Q000601:surgery*; D006351:Heart Valves / Q000473:pathology; D015395:Histocompatibility Antigens Class I; D000949:Histocompatibility Antigens Class II; D006650:Histocompatibility Testing; D006801:Humans; D007158:Immunologic Techniques; D007166:Immunosuppressive Agents / Q000494:pharmacology; D007223:Infant; D007231:Infant, Newborn; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000494:pharmacology; D010865:Pilot Projects; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D000906:Antibodies; D006680:HLA Antigens; D015395:Histocompatibility Antigens Class I; D000949:Histocompatibility Antigens Class II; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid