Comparison of HLA & MICA Allosensitization Patterns among Patients Supported by Ventricular Assist Devices (VAD) and Patients with No Devices

The impact of angiotensin II type 1 receptor antibodies on post-heart transplantation outcome in Heart Mate II bridged recipients

“…One of the proposed limitations of mechanical device support therapy is a higher degree of sensitization among LVAD recipients. Apart from antibodies directed against human leucocyte antigen (HLA), several non-HLA antibodies like major histocompatibility class I-related chain, autoantibodies against angiotensin II type 1 receptor (AT1R) and endothelin receptor A as well as antibodies to cardiac self-antigens (myosin and vimentin) have been associated with an LVAD use [3][4][5][6]. AT1R differs from all other non-HLA antigenic targets in the mechanism of action.…”

The dilemma of the role of the non‐HLA antibodies in AMR

“…There is increased recognition of the pathogenic role of non-HLA antibodies in the development of AMR and cardiac allograft vasculopathy (CAV) after HT. 3 Moreover, the development of non-HLA antibodies in patients with continuous-flow left ventricular assist device (cfLVAD) support has been described, 4 raising the concern that patients with temporary MCS might develop it. Similarly, sensitization has been reported with underlying inflammatory diseases such as myocarditis.…”