Document Detail


Influence of panel reactive antibodies (PRA) on perioperative course in patients undergoing elective cardiac surgery procedures, and impact of these procedures on PRA occurrence.
MedLine Citation:
PMID:  17715571     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cardiac surgery is supposed to be a risk factor of PRA formation, however the role of PRA presence in non-transplant subjects is not known. Aim of the study was to assess PRA occurrence in patients undergoing elective cardiosurgery procedures and to evaluate its influence on the perioperative course. MATERIAL AND METHODS: Blood samples were obtained before operation in 44 subjects (36M/8F; 55.9 +/- 8.1 y/o) undergoing primary elective cardiosurgery procedures--CABG (n = 30), CABG + valve (n = 2) or valve procedure (n = 12). PRA results were obtained after the discharge, and patients were retrospectively divided into: Group A (n = 18) with PRA > 1%, and Group B (n = 26) with PRA. < or = 1%. PRA screening was repeated 3 months after the procedure in 41 subjects. They were divided into Group I (n = 13) with PRA > 1%, and Group II (n = 28) with PRA < or = 1%. Comparison was performed of Groups A vs. B, and I vs. II. RESULTS: Differences in pre-operative characteristics and procedure type distribution were insignificant. Post-operative complications were more frequent in Groups A and I (pulmonary hypertension in Group I vs. II: 38 vs. 4%; p = 0.01). Duration of post-operative ICU stay was longer in Group I vs. 11 (2.9 vs. 1.9d.; p = 0.01). Overall hospital stay was longer in Group A vs. B (10.1 vs. 7.8d.; p = 0.054). Increase of PRA titers was observed in 10 subjects (3 pts. /17% from Group A, and 7 pts. /27% from Group B), exceeding 10% in 2 females after valve replacement. 6 months after procedure, detectable PRA was still observed in 7 patients. CONCLUSIONS: Cardiac surgery is not a strong causative factor of PRA formation. The presence of perceptible PRA level may be associated with increased incidence of complications and consequently prolonged in-hospital stay. Influence of PRA on peri-operative course is not dependent on the source of its increased level.
Authors:
Michał Zakliczyński; Lukasz Pyka; Dominika Trybunia; Anna Krynicka; Piotr Wilczek; Marcin Maruszewski; Paweł Nadziakiewicz; Mirosława Herdyńska-Was; Roman Przybylski; Marian Zembala
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of transplantation : quarterly of the Polish Transplantation Society     Volume:  11     ISSN:  1425-9524     ISO Abbreviation:  Ann. Transplant.     Publication Date:  2006  
Date Detail:
Created Date:  2007-08-24     Completed Date:  2007-09-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9802544     Medline TA:  Ann Transplant     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  4-11     Citation Subset:  IM    
Affiliation:
Katedra i Oddział Kliniczny Kardiochirurgii i Transplantologii SAM, Slaskie Centrum Chorób Serca w Zabrzu, zaklimed@onet.pl
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MeSH Terms
Descriptor/Qualifier:
Adult
Antibody Formation
Coronary Artery Bypass / adverse effects*
Female
HLA Antigens / immunology*
Heart Valve Prosthesis Implantation / adverse effects*
Humans
Incidence
Intensive Care Units
Length of Stay
Male
Middle Aged
Postoperative Complications / epidemiology*
Preoperative Care
Retrospective Studies
Sex Factors
Chemical
Reg. No./Substance:
0/HLA Antigens

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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