BACKGROUND AND OBJECTIVE:
Kawasaki disease (KD) may result in coronary aneurysm formation, but there is incomplete knowledge regarding its long-term effects. Our objective was to quantify the longer-term rates of adverse cardiac events in a modern North American KD cohort.
METHODS:
Using the Kaiser Permanente Northern California population, we performed a retrospective cohort study in patients with a history of KD versus matched patients without KD. Chart review was used to confirm the diagnosis of KD and all outcomes of interest, including acute coronary syndrome, coronary revascularization, heart failure, ventricular arrhythmia, valve disease, aortic aneurysm, and all-cause mortality. All outcomes occurring at age ≥15 years were included in the primary analysis. Outcome rates were compared between the 2 groups by using Cox proportional hazards analysis.
RESULTS:
The study included 546 KD patients and 2218 matched patients without KD. Seventy-nine percent of the KD patients received intravenous immunoglobulin and 5% had persistent coronary aneurysm. The average follow-up time was 14.9 years. Only 2 KD patients experienced outcomes after age 15 (0.246 events per 1000 person-years) compared with 7 events in the non-KD group (0.217 events per 1000 person-years), a nonsignificant difference (hazard ratio: 0.81; 95% confidence interval: 0.16–4.0). Within the KD subgroup, persistent coronary aneurysm predicted the occurrence of adverse events (P = .007).
CONCLUSIONS:
This is the largest US study of longer-term cardiac outcomes after KD and reveals a low rate of adverse cardiovascular events through age 21. Additional validation studies, including studies with longer-term follow-up, should be performed.
Background
Leukocytes collected from hematopoietic stem cell transplant donors are often given to the recipient to speed immune recovery or treat disease relapse. The post-thaw recovery and viability of cryopreserved donor leukocytes, stored for as long as seven years, was assessed.
Methods
Total nucleated cell (TNC) cell recovery, CD3+ cell recovery, and TNC viability were measured in 311 clinical donor leukocyte products: 168 products were unmanipulated or minimally manipulated and 143 products were extensively manipulated. An additional 45 products were selected because they were stored for a longer duration; these were tested using both standard methods and global transcriptional analysis. All products were cryopreserved in 5% DMSO plus 6% pentastarch and stored in liquid nitrogen.
Results
The mean duration of storage of the 311 products was 143 days. Their TNC recovery was 92 ± 17%, CD3+ cell recovery was 76 ± 19% and the TNC viability was 84 ± 6%. Duration of storage had no effect on TNC recovery, CD3+ cell recovery or TNC viability of the 311 products. The mean duration of storage of the long-term stored products was 5.2 years; their TNC recovery (93 ± 14%) and the TNC viability (78 ± 13%) did not differ from the 311 products, but their CD3 cell recovery was greater (86 ± 22%; p=0.0042). Gene expression profiles of the long-term stored products revealed no differences due to storage duration.
Conclusions
Donor leukocyte products cryopreserved in 5% DMSO and 6% pentastarch can be stored in liquid nitrogen for at least 7 years.
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