| Association of device surface and biomaterials with immunologic sensitization after mechanical support. | |
| | |
MedLine Citation:
|
PMID: 18544389 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: Biomaterials and textured surfaces in early pulsatile left ventricular assist devices (HeartMate I; Thoratec Corporation, Pleasanton, Calif) may increase immunologic risk through allosensitization. We hypothesized that axial-flow devices without biologic membranes or textured surfaces (HeartMate II; Thoratec; and DeBakey; MicroMed Cardiovascular, Inc, Houston, Tex) would cause less allosensitization than devices with such membranes and surfaces. METHODS: HeartMate II and DeBakey (n = 24) and HeartMate I (n = 36) devices were implanted from 1999 to 2006 in patients with severe heart failure cohort-matched for age, etiology, and support duration. Serum samples reacting with more than 10% of the HLA reference panel were considered positive for anti-HLA antibodies. Endomyocardial biopsy samples were collected after transplant. RESULTS: There were no significant cohort differences in age, etiology, sex, blood transfusion, or support duration. Anti-HLA antibodies were not detected at implantation of either HeartMate II and DeBakey or HeartMate I devices; however, significant increases in anti-HLA antibodies were present within 1 and 3 months of support with HeartMate I but not HeartMate II and DeBakey devices. Overall, fewer patients with HeartMate II and DeBakey devices demonstrated positive anti-HLA antibodies during support (8% vs 28%, P = .02), and fewer episodes of acute rejection per patient were seen within the first 9 posttransplant months(0.31 vs 0.69, P = .052). Long-term posttransplant survival was not different between groups. CONCLUSION: Hemodynamic support with HeartMate II and DeBakey devices produced less allosensitization than did HeartMate I devices. Device selection may improve clinical outcomes for high-risk patients. |
| | |
Authors:
|
Isaac George; Patrick Colley; Mark J Russo; Timothy P Martens; Elizabeth Burke; Mehmet C Oz; Mario C Deng; Donna M Mancini; Yoshifumi Naka |
Related Documents
:
|
8604929 - Ventricular assist devices in pediatric cardiac surgery. 19732979 - Use of impella recover lp 2.5 in elective high risk percutaneous coronary intervention. 8889879 - Mechanisms of dynamic cardiomyoplasty: current concepts. 20408809 - New devices for treating acute ischemic stroke. 20308889 - New diagnostic devices in heart failure. 15365519 - Impella recover 100: successful perioperative support for off pump coronary artery bypa... 6338889 - Effect of very early intervention with metoprolol on myocardial infarct size. 19038389 - Staccato reperfusion prevents reperfusion injury in patients undergoing coronary angiop... 2575179 - Blood pressure and lipid lowering effects of terazosin. |
Publication Detail:
|
Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
|
Title: The Journal of thoracic and cardiovascular surgery Volume: 135 ISSN: 1097-685X ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2008 Jun |
Date Detail:
|
Created Date: 2008-06-11 Completed Date: 2008-07-15 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
|
Languages: eng Pagination: 1372-9 Citation Subset: AIM; IM |
Affiliation:
|
Department of Surgery, Division of Cardiothoracic Surgery, College of Physicians and Surgeons of Columbia University, New York, NY, USA. isaacgeorge@hotmail.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Coated Materials, Biocompatible Equipment Design Equipment Failure Female HLA Antigens / immunology* Heart Failure / immunology*, mortality, surgery* Heart-Assist Devices* Humans Immunization / methods* Kaplan-Meiers Estimate Male Materials Testing Middle Aged Retrospective Studies Risk Assessment Severity of Illness Index Survival Analysis |
| Grant Support | |
ID/Acronym/Agency:
|
T32-HL07854/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Coated Materials, Biocompatible; 0/HLA Antigens |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Extracorporeal lung membrane provides better lung protection than conventional treatment for severe ...
Next Document: Tissue factor-independent effects of recombinant factor VIIa on hemostasis.