title: Incidence and early outcomes associated with pre-transplant antivimentin antibodies in the cardiac transplantation population.
abstract: BACKGROUND
  In cardiac transplant recipients, the development of antibodies to the endothelial intermediate filament protein vimentin (antivimentin antibodies, AVA) has been associated with rejection and poor outcomes. However, the incidence of these antibodies prior to transplantation and their association with early rejection has not been investigated.
  
  
  METHODS
  Pre-transplant serum was analyzed from 50 patients who underwent de novo cardiac transplant at Johns Hopkins Hospital from 2004 to 2012. Demographic, one-yr rejection, and survival data were obtained from the transplant database.
  
  
  RESULTS
  The incidence of pre-transplant AVA was 34%. AVA-positive patients were younger (p = 0.03), and there was an a trend toward incidence in females (p = 0.08). Demographic data were similar among both groups. AVA positivity did not predict rejection in the first year post-transplant. There was no difference in rejection-free graft survival (53 vs. 52%, p = 0.85) at one yr. Similarly, there was no difference in graft survival at one yr (82 vs. 88%, p = 0.56) or graft survival at a median follow-up of 23 and 26 months, respectively (76 vs. 85%, p = 0.41).
  
  
  CONCLUSIONS
  AVA is common in the cardiac pre-transplant population with a higher incidence in the young. The presence of detectable AVA did not correlate with early post-transplant rejection or graft survival.
authors.affiliation: Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Raymond K
authors.initials: RK
authors.lastname: Young
authors.affiliation: Division of Immunogenetics and Transplantation Immunology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Bethany
authors.initials: B
authors.lastname: Dale
authors.affiliation: Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Stuart D
authors.initials: SD
authors.lastname: Russell
authors.affiliation: Division of Immunogenetics and Transplantation Immunology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Zachary
authors.affiliation: Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Tedford
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D015142:Baltimore / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D006085:Graft Survival; D006331:Heart Diseases / Q000150:complications / Q000601:surgery*; D016027:Heart Transplantation; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014746:Vimentin / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D014746:Vimentin
keywords: anti-vimentin antibodies; cardiac transplantation; non-HLA antibodies; pre-transplant; transplant rejection