Korean J Transplant.  2022 Nov;36(Supple 1):S339. 10.4285/ATW2022.F-4843.

Prognostic value of anti-vimentin antibodies in pre-sensitized heart transplant patients

• Lee HY
• Oh GC
• Oh J
• Cho HJ
• Choi JO
• Jung SH
• Jeon JJ
• Jeon ES
• Kang SM

• KMID: 2535566
• DOI: http://doi.org/10.4285/ATW2022.F-4843

Abstract

Background
Presence of antibodies to donor specific human leukocyte antigens (HLA) is a well-known risk factor associated with outcome in solid organ transplantation. Recent studies have suggested that non-HLA antibodies could also be associated with outcomes in heart transplantation (HTx). We sought to assess the combined effect of donor specific HLA antibodies and non-HLA anti-vimentin antibodies on graft outcome in Korean HTx patients.
Methods
Pretransplant serum was analyzed in 192 adult patients who underwent HTx from January 2014 to December 2016 in four large transplant centers in Korea. Demographic and outcome data were obtained from the Korean Organ Transplantation Registry, an organization established in 2014 to collect data on transplant patients.
Results
Donor-specific HLA antibodies (DSA) were present in 28 patients (14.6%), while anti-vimentin antibodies were present in 98 patients (51.0%). Anti-vimentin antibodies were more prevalent in males (P=0.029), but there were no significant differ-ences in other demographic factors. Positive DSA was associated with a significantly higher rate of 3-month graft failure (logrank P=0.001). Anti-vimentin antibody positivity was also an independent predictor for 3-month and 1-year graft failure (hazard ratio [HR] _adjust , 5.21; 95% confidence interval [CI], 1.66–16.37; P=0.005; HR _adjust , 3.45; 95% CI, 1.47–8.09; P=0.004, respectively). In DSA(+) patients, anti-vimentin antibody positivity further discriminated 1-year graft survival (long-rank P=0.002).
Conclusions
In our analysis of Korean HTx patients, DSA and anti-vimentin antibodies were both associated with increased risk of graft failure at 1 year. Additionally, anti-vimentin antibody positivity was able to further discriminate outcome in patients undergoing pre-sensitized HTx. Pretransplant assessment of anti-vimentin antibodies could help predict outcome and tailor immuno-therapy in specific patients.