Elevated Plasma Immunoglobulin Levels Prior to Heart Transplantation Are Associated with Poor Post-Transplantation Survival

Elevated Plasma Immunoglobulin Levels Prior to Heart Transplantation Are Associated with Poor Post-Transplantation Survival

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Cardiac allograft vasculopathy (CAV) and antibody-mediated rejection are immune-mediated, long-term complications that jeopardize graft survival after heart transplantation (HTx).Interestingly, increased plasma levels of immunoglobulins have been found in end-stage heart failure (HF) patients prior to HTx.In this study, we aimed to determine whether increased circulating immunoglobulin levels prior to transplantation are associated with poor post-HTx survival.Pre-and post-HTx plasma samples of 36 cardiac transplant recipient patients were used to determine circulating immunoglobulin levels.

In addition, epicardial tissue Basketball - Clothing - Junior was collected to determine immunoglobulin deposition in cardiac tissue and assess signs and severity of graft rejection.High levels of IgG1 and IgG2 prior to HTx were associated with a shorter survival post-HTx.Immunoglobulin deposition in cardiac tissue was significantly elevated in patients with a survival of less than 3 years.Patients with high plasma IgG 4 Casters levels pre-HTx also had significantly higher plasma levels after HTx.

Furthermore, high pre-HTX levels of IgG1 and IgG2 levels were also significantly increased in patients with inflammatory infiltrate in CAV lesions.Altogether the results of this proof-of-concept study suggest that an activated immune response prior to transplantation negatively affects graft survival.