The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2021
Higher levels of allograft injury in black patients early after heart transplantation.
СтатьяПоддержка NIH: внешняя программаResearch Support, N.I.H., IntramuralНазвание и аннотация: Перевод в очереди
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Doshi Amar, Shah Keyur B, Agbor-Enoh Sean, Tushak Zackary, Garcia Victoria, Kong Hyesik, Jang Moon K, Hsu Steven, Feller Erika D, Rodrigo Maria E, Najjar Samer S, Tunc Ilker, Yang Yanqin, Lee Seiyon, Solomon Michael A, Berry Gerald, Marboe Charles, Shah Palak, Valantine Hannah A
Аннотация
Black patients suffer higher rates of antibody-mediated rejection and have worse long-term graft survival after heart transplantation. Donor-derived cell free DNA (ddcfDNA) is released into the blood following allograft injury. This study analyzed %ddcfDNA in 63 heart transplant recipients categorized by Black and non-Black race, during the first 200 days after transplant. Immediately after transplant, %ddcfDNA was higher for Black patients (mean [SE]: 8.3% [1.3%] vs 3.2% [1.2%], p = 0.001). In the first week post-transplant, the rate of decay in %ddcfDNA was similar (0.7% [0.68] vs 0.7% [0.11], p = 0.78), and values declined in both groups to a comparable plateau at 7 days post-transplant (0.46% [0.03] vs 0.45% [0.04], p = 0.78). The proportion of Black patients experiencing AMR was higher than non-Black patients (21% vs 9% [hazard ratio of 2.61 [95% confidence interval: 0.651-10.43], p = 0.18). Black patients were more likely to receive a race mismatched organ than non-Black patients (69% vs 35%, p = 0.01), which may explain the higher levels of early allograft injury.