Impact of ELISA-detected anti-HLA antibodies on pediatric cardiac allograft outcome

Sylvie Di Filippo, Alin Girnita, Steven A. Webber*, Sabrina Tsao, Gerard J. Boyle, Susan A. Miller, Sanjiv K. Gandhi, Adriana Zeevi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


In this study, we determine whether the presence of enzyme-linked immunosorbent assay (ELISA) detected anti-human leukocyte antigen (HLA) antibodies correlates with acute and chronic rejection in pediatric heart transplantation (Tx). Forty-five patients, who had serial ELISA pre- and posttransplantation, were studied. Age at Tx was 8.2 ± 7.2 years. Acute rejection (AR) was defined as International Society for Heart and Lung Transplantation Grade ≥3a. Patients were defined as rejectors (22 cases) if they had recurrent AR or steroid-resistant AR within the first year post-Tx; the other cases (23) were defined as nonrejectors. Overall, 219 samples were analyzed. Twenty-two of the 45 had pre- or post-Tx anti-HLA antibodies: 77% in rejectors (17/22) and only 22% in nonrejectors (5/23), p = 0.0002. Pre-Tx HLA antibodies were present in 12 cases (27%). Presensitization was more frequent in rejectors (11/22, 50%) than in nonrejectors (1/23, 4%, p = 0.0005). Nineteen cases retained (9 cases) or developed (10 cases) anti-HLA antibodies post-Tx: 14 in rejectors (63.6%) and 5 in nonrejectors (21.7%), p = 0.003. Four of eight cases with coronary artery disease (50%) had preformed anti-HLA antibodies compared with 8 of 37 without coronary artery disease (25.6%) (p = 0.09). Preformed, persistent, and de novo ELISA-detected anti-HLA antibodies were correlated with first-year acute rejection profile.

Original languageEnglish (US)
Pages (from-to)513-518
Number of pages6
JournalHuman Immunology
Issue number5
StatePublished - May 2005


  • AR acute rejection
  • CAD coronary artery disease
  • EMB endomyocardial biopsies
  • HLA human leukocyte antigen
  • PRA panel-reactive antibody

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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