Ontology type: schema:Chapter
1997
AUTHORSF. M. E. Hoekstra , C. Knoop , E. Bos , N. Jutte , C. Wassenaar , W. Weimar
ABSTRACTFresh and cryopreserved human valves are used to reconstruct ventricular outflow tracts. Valve donor and recipient are not matched for blood group or human leukocyte antigens (HLA) and immunosuppressive therapy is not routinely given to valve recipients. Therefore, immunologic activity of the valve acceptor against allogeneic tissue may play a role in valve destruction. In this study, we examined the immunogenicity of human donor valves in vitro. Pieces of fresh and cryopreserved leaflets derived from the same valve allograft, and endothelial cells derived from fresh valve leaflets, were tested as stimulator in a lymphocyte proliferation assay. Lymphocytes mismatched or matched for HLA-DR with the valve donors were used as responders. The proliferation was expressed as Stimulation Index (SI). The SI was significantly higher with fresh valve pieces as stimulator (median SI: 9; range 4–117) compared to cryopreserved valves (p = 0.002, Wilcoxon), although the latter were still able to induce lymphoproliferation (median SI: 2; range 1–9). The SI was significantly lower when lymphocytes were matched for HLA-DR with the valve donor (median SI: 1, range 1–5) compared to the HLA-DR mismatched group (median SI: 5; range 2–117, p = 0.006, Wilcoxon). Endothelial cells derived from six different valves, incubated with lymphocytes mismatched for HLA-A, B and DR, induced a median SI of 8 (range: 3–15). These results indicate that both fresh and cryopreserved human valves are able to evoke a proliferative response of immune competent cells in vitro. Also, both matching for HLA-DR between valve donor and responder lymphocytes and the cryopreservation procedure are associated with a significantly decreased lymphoproliferative response. Finally, the endothelial cells present on fresh valves probably play a prominent role in the immune response against human valve allografts. More... »
PAGES69-74
Cardiac Valve Allografts
ISBN
978-3-642-63915-9
978-3-642-59250-8
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