Letter to the Editor

Manji, Jacqueline S.; Rajotte, Ray V.; Koshal, Arvind; Manji, Rizwan A.

doi:10.1111/j.1399-3089.2004.00141.x

Cited by 4 publications

(1 citation statement)

References 4 publications

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“…The α-Gal titer antibodies increase after bioprosthesis implantation [14] [15]. The α-Gal is structurally almost identical to the human group B-antigen [16,17] and, although the subject of some discussion [[18], [19], [20]], B-type patients may have a better tolerance towards this and related antigens [21] [19]. Bioprostheses obtained from Gal-Knockout pigs are possibly less immunogenic in New World primates [22].…”

Section: Introductionmentioning

confidence: 99%

Recipients with blood group A associated with longer survival rates in cardiac valvular bioprostheses

Schussler¹,

Lila

Perneger³

et al. 2019

EBioMedicine

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Background Pigs/bovines share with humans some of the antigens present on cardiac valves. Two such antigens are: the major xenogenic Ag, “Gal” present in all pig/bovine very close to human B-antigen of ABO-blood-group system; the minor Ag, pig histo-blood-group AH-antigen identical to human AH-antigen and present by some animals. We hypothesize that these antigens may modify the immunogenicity of the bioprosthesis and also its longevity. ABO distribution may vary between patients with low (<6 years) and high (≥15 years) bioprostheses longevity. Methods Single-centre registry study (Paris, France) including all degenerative porcine bioprostheses (mostly Carpentier-Edwards 2nd/3rd generation heart valves) explanted between 1985 and 1998 and some bovine bioprostheses. For period 1998–2014, all porcine bioprostheses with longevity ≥13 years (follow-up ≥29 years). Important predictive factors for bioprosthesis longevity: number, site of implantation, age were collected. Blood group and other variables were entered into an ordinal logistic regression analysis model predicting valve longevity, categorized as low (<6 years), medium (6–14.9 years), and high (≥15 years). Findings Longevity and ABO-blood group were obtained for 483 explanted porcine bioprostheses. Mean longevity was 10.2 ± 3.9 years [0–28] and significantly higher for A-patients than others ( P = 0.009). Using multivariate analysis, group A was a strong predictive factor of longevity (OR 2.09; P < 0.001). For the 64 explanted bovine bioprosthesis with low/medium longevity, the association, with A-group was even more significant. Interpretation Patients of A-group but not B have a higher longevity of their bioprostheses. Future graft-host phenotyping and matching may give rise to a new generation of long-lasting bioprosthesis for implantation in humans, especially for the younger population. Fund None.

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