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Evaluation of humoral immunity profiles to identify heart recipients at risk for development of severe infections: a multicenter prospective study
dc.contributor.author | Sarmiento, Elizabeth | |
dc.contributor.author | Jaramillo, María | |
dc.contributor.author | Calahorra, Leticia | |
dc.contributor.author | Fernández-Yáñez, Juan | |
dc.contributor.author | Gómez-Sánchez, Miguel | |
dc.contributor.author | Crespo-Leiro, María Generosa | |
dc.contributor.author | Paniagua-Martín, María J. | |
dc.contributor.author | Almenar-Bonet, Luis | |
dc.contributor.author | Cebrián, Mónica | |
dc.contributor.author | Rábago, Gregorio | |
dc.contributor.author | Levy, Beltrán | |
dc.contributor.author | Segovia-Cubero, Javier | |
dc.contributor.author | Gómez-Bueno, Manuel | |
dc.contributor.author | López, Javier | |
dc.contributor.author | Mirabet, Sonia | |
dc.contributor.author | Navarro, Joaquín | |
dc.contributor.author | Rodríguez-Molina, Juan José | |
dc.contributor.author | Fernández-Cruz, Eduardo | |
dc.contributor.author | Carbone, Javier | |
dc.date.accessioned | 2019-03-29T08:16:59Z | |
dc.date.available | 2019-03-29T08:16:59Z | |
dc.date.issued | 2017 | |
dc.identifier.citation | Sarmiento E, Jaramillo M, Calahorra L, et al. Evaluation of humoral immunity profiles to identify heart recipients at risk for development of severe infections: a multicenter prospective study. J Heart Lung Transplant. 2017; 36(5): 529-539 | es_ES |
dc.identifier.issn | 1053-2498 | |
dc.identifier.uri | http://hdl.handle.net/2183/22418 | |
dc.description.abstract | [Abstract] BACKGROUND: New biomarkers are necessary to improve detection of the risk of infection in heart transplantation. We performed a multicenter study to evaluate humoral immunity profiles that could better enable us to identify heart recipients at risk of severe infections. METHODS: We prospectively analyzed 170 adult heart recipients at 8 centers in Spain. Study points were before transplantation and 7 and 30 days after transplantation. Immune parameters included IgG, IgM, IgA and complement factors C3 and C4, and titers of specific antibody to pneumococcal polysaccharide antigens (anti-PPS) and to cytomegalovirus (CMV). To evaluate potential immunologic mechanisms leading to IgG hypogammaglobulinemia, before heart transplantation we assessed serum B-cell activating factor (BAFF) levels using enzyme-linked immunoassay. The clinical follow-up period lasted 6 months. Clinical outcome was need for intravenous anti-microbials for therapy of infection. RESULTS: During follow-up, 53 patients (31.2%) developed at least 1 severe infection. We confirmed that IgG hypogammaglobulinemia at Day 7 (defined as IgG <600 mg/dl) is a risk factor for infection in general, bacterial infections in particular, and CMV disease. At Day 7 after transplantation, the combination of IgG <600 mg/dl + C3 <80 mg/dl was more strongly associated with the outcome (adjusted odds ratio 7.40; 95% confidence interval 1.48 to 37.03; p = 0.014). We found that quantification of anti-CMV antibody titers and lower anti-PPS antibody concentrations were independent predictors of CMV disease and bacterial infections, respectively. Higher pre-transplant BAFF levels were a risk factor of acute cellular rejection. CONCLUSION: Early immunologic monitoring of humoral immunity profiles proved useful for the identification of heart recipients who are at risk of severe infection. | es_ES |
dc.description.sponsorship | Instituto de Salud Carlos III; FIS081430 | es_ES |
dc.description.sponsorship | Instituto de Salud Carlos III; FIS1101323 | es_ES |
dc.description.sponsorship | Instituto de Salud Carlos III; FIS1501472 | es_ES |
dc.language.iso | eng | es_ES |
dc.publisher | Elsevier | es_ES |
dc.relation.uri | https://doi.org/10.1016/j.healun.2016.10.004 | es_ES |
dc.rights | Atribución-NoComercial-SinDerivadas 3.0 España | es_ES |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/es/ | * |
dc.subject | Complement | es_ES |
dc.subject | Heart transplantation | es_ES |
dc.subject | Hypogammaglobulinemia | es_ES |
dc.subject | Infection | es_ES |
dc.subject | Risk factor | es_ES |
dc.title | Evaluation of humoral immunity profiles to identify heart recipients at risk for development of severe infections: a multicenter prospective study | es_ES |
dc.type | info:eu-repo/semantics/article | es_ES |
dc.rights.access | info:eu-repo/semantics/openAccess | es_ES |
UDC.journalTitle | The Journal of Heart and Lung Transplantation | es_ES |
UDC.volume | 36 | es_ES |
UDC.issue | 5 | es_ES |
UDC.startPage | 529 | es_ES |
UDC.endPage | 539 | es_ES |
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