title: Lack of significant de novo HLA allosensitization in ventricular assist device recipients transfused with leukoreduced, ABO identical blood products.
abstract: Ventricular assist devices provide support for a failing heart and often serve as a bridge to transplantation. The use of these devices has also been associated with allosensitization to HLA antigens because of transfusion of blood products. Our program established a protocol mandating the use of leukoreduced, irradiated and ABO identical products, including platelets, in patients receiving initial implantations of VADs as a bridge to transplantation. Recipients were tested for anti-HLA antibodies before VAD implantation and monthly post-implantation by cytotoxicity and solid phase assays. We observed minimal de novo anti-HLA sensitization (<10%) in this population of 55 patients, each receiving a mean of 90 blood components, using this approach. No patient developed broad sensitization (PRA>50%). In conclusion, The use of leukoreduced, irradiated, ABO identical blood products abrogates broad allosensitization in this highly transfused population.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Strong Memorial Hospital, Rochester, NY, USA. myra_coppage@urmc.rochester.edu
authors.forename: Myra
authors.initials: M
authors.lastname: Coppage
authors.forename: Marc
authors.initials: M
authors.lastname: Baker
authors.forename: Lawrence
authors.initials: L
authors.lastname: Fialkow
authors.forename: Danielle
authors.initials: D
authors.lastname: Meehan
authors.forename: Kelly
authors.initials: K
authors.lastname: Gettings
authors.forename: Leway
authors.initials: L
authors.lastname: Chen
authors.forename: H Todd
authors.initials: HT
authors.lastname: Massey
authors.forename: Neil
authors.initials: N
authors.lastname: Blumberg
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D005260:Female; D006680:HLA Antigens / Q000276:immunology*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D007518:Isoantibodies / Q000097:blood; D047589:Leukocyte Reduction Procedures; D007962:Leukocytes / Q000276:immunology; D008297:Male; D008875:Middle Aged
chemical_list: D000017:ABO Blood-Group System; D006680:HLA Antigens; D007518:Isoantibodies