Graduation Date

Fall 12-2015

Document Type

Thesis

Degree Name

Master of Science (MS)

Programs

Epidemiology

First Advisor

Lorena Baccaglini

Second Advisor

Jane Meza

Third Advisor

Brian D Lowes

Abstract

Objectives: To evaluate the role of preexisting Angiotensin II receptor type I antibodies (AT1RAb) and anti-HLA antibodies in predicting mortality and cardiac allograft vasculopathy (CAV) among heart transplant patients.

Methods: In this retrospective cohort study, we included 114 adults who received heart transplant from January 1st, 2007 to December 31, 2014 and were followed up at Nebraska Medicine. 48 hours pre-transplant sera sample were used to detect antibodies. A cutoff of 10UL/ml was used for AT1RAb positive and mean fluorescence intensity of 3,000 and 1,500 were used for anti HLA class I and class II, respectively. Patients were positive for composite antibodies if they were positive for anti-HLA, or AT1R antibodies. Survival analysis was conducted to compare the risk for mortality or CAV between antibody positive and negative groups.

Result: Participants who had positive composite antibodies had higher probability of having CAV (p=0.05). Participants who were negative for AT1RAb trended toward a lower risk of mortality or developing CAV compared to AT1RAb positive counterparts.

Conclusion: Positive status for any of anti-HLA or AT1RAb increased the risk of CAV. AT1RAb positivity is possibly linked with higher risk of death or developing CAV. Future study can focus on verifying these trends and the potential interaction effect between anti-HLA and AT1R antibodies.

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