immune response following fresh arterial homograft replacement for aortoiliac graft infection.

NLM AIDSLINE Immune response following fresh arterial homograft replacement for aortoiliac graft infection. Mirelli M; Stella A; Faggioli GL; Scolari MP; Iannelli S; Freyrie A;
March 30, 2000

Eur J Vasc Endovasc Surg. 1999 Nov;18(5):424-9. Unique Identifier : INTRODUCTION: this prospective study defines the immune response to fresh arterial homograft replacement for graft infection. MATERIALS AND METHODS: ten patients who underwent ABO-compatible homograft transplantation were studied for anti-HLA antibody production, and CD3-CD4-CD8-positive lymphocytes subset. Immunological studies were performed preoperatively, and at early (1, 3, 7 days) and late (1, 3, 6, 12, 18, 24 months) follow-up. All patients received immunosuppressive treatment with cyclosporine (1-3 mg/kg/day). Abdominal CT scans were performed postoperatively at the 1, 6, 12, 18, 24 months follow-up. RESULTS: preoperatively, antibodies could not be detected. Postoperatively, as from 1st month post-transplant, a progressive increase in % PRA was observed in all patients, up to the 12th month of follow-up. Subsequently, at 18 and 36 months, a progressive decrease in % PRA was detected. Data showed that the recipient antibodies were directed against donor-specific antigens. During the immediate postoperative period (1, 3, 7 days) CD3- and CD4-positive T lymphocytes slightly increased, whereas CD8 simultaneously decreased. Later, CD3 and CD4 progressively decreased and CD8 increased. Clinically, all patients were cured of infection at late follow-up. CT scans showed thickening of the aortic wall (range: 2.5-4.5 mm), with no signs of aneurysmal degeneration. CONCLUSIONS: fresh arterial homografts are immunogenic. Implanted homografts induce a strong anti-HLA antibody response, similar to chronic rejection, in spite of immunosuppressive treatment. Copyright 1999 Harcourt Publishers Ltd. JOURNAL ARTICLE Aged Antibody Specificity/IMMUNOLOGY Antigens, CD3/IMMUNOLOGY Aorta, Abdominal/SURGERY Arteries/IMMUNOLOGY/TRANSPLANTATION ABO Blood-Group System/IMMUNOLOGY Blood Vessel Prosthesis/ADVERSE EFFECTS Comparative Study CD4-Positive T-Lymphocytes/IMMUNOLOGY CD8-Positive T-Lymphocytes/IMMUNOLOGY Femoral Artery/SURGERY Human HLA Antigens/IMMUNOLOGY Iliac Artery/SURGERY Male Middle Age Prospective Studies Prosthesis-Related Infections/*IMMUNOLOGY/SURGERY Reoperation Time Factors Transplantation Immunology/IMMUNOLOGY Transplantation, Homologous

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