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Agenda

This study examines the association between HLA antibody (PRA) and post-transplant outcomes in pediatric heart recipients, finding that an elevated PRA determined by solid phase assay remains a significant risk factor in the modern era.

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Agenda

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Presentation Transcript

  1. Agenda

  2. 2017 Scientific Committee Members

  3. Submitted Manuscripts Status: November 2017

  4. Manuscripts in Preparation Status: November 2017

  5. Manuscripts in Preparation Status: November 2017

  6. Abstracts Submitted to ISHLT 2018

  7. Publications: May 2017 – November 2017 5 Publications

  8. Recent Publications American Journal of Transplantation, Volume 17, Issue 6, June 2017, Pages 1525–1539

  9. Recent Publications The Journal of Heart and Lung Transplantation  Volume 36, Issue 9, September 2017, Pages 996–1003

  10. Recent Publications European Heart Journal, Volume 38, Issue 38, October 2017, pages 2900 - 2909

  11. Recent Publications: In Press The Journal of Heart and Lung Transplantation, Accepted May 2017. In Press

  12. Recent Publications: In Press Pediatric Transplantation, Accepted October 2017, In Press The Impact of Flow PRA on Outcome in Pediatric Heart Recipients in Modern Era: An Analysis of the Pediatric Heart Transplant Study Database Das B. B., MD,a Pruitt E., MSPH,b Molina K., MD,c Ravekes W., MD,d Auerbach S., MD,e Savage A., MD,f Knox L., RN, BSN, CCTC,g Kirklin J. K., MD,b Naftel D.C., PhD,b Hsu D., MD;h on behalf of the Pediatric Heart Transplant Study Investigators Abstract Data from patients in the Pediatric Heart Transplant Study (PHTS) registry transplanted between 2010 and 2014 were analyzed to determine the association between HLA antibody (PRA) determined by solid phase assay (SPA) using Luminex or flow cytometry with a positive retrospective crossmatch and the post-transplant outcomes of acute rejection and graft survival. A total of 1459/1596 (91%) recipients had a PRA reported pre-transplant; 26% had a PRA >20%. Patients with a PRA>20% were more likely to have congenital heart disease, prior cardiac surgery, extracorporeal membrane oxygenation support at listing, and waited longer for transplantation than patients with a PRA <20%. Patients with higher PRA% determined by SPA were predictive of a positive retrospective crossmatch determined by flow cytometric method (p<0.001). A PRA >50% determined by SPA was independently associated with worse overall graft survival after first month of transplant in both unadjusted and adjusted for all other risk factors. In this large multicenter series of pediatric heart transplant recipients, an elevated PRA determined by SPA remains a significant risk factor in the modern era.

  13. Presentations at AHA

  14. AHA 2017 Rapid-Fire Oral PresentationMonday, November 13, 10:10am – 11:20amClinical III Forum, Science and Technology Hall Anna Joong1, Elizabeth Pruitt2, Warren A. Zuckerman3, James W. Blackston2, Rebecca K. Ameduri4, Juan C. Alejos5, Gerard J. Boyle6, AmyC. Rothkopf3, James K. Kirklin2, and Robert J. Gajarski7 1Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL; 2University of Alabama at Birmingham, Birmingham, AL; 3Columbia University-Morgan Stanley Children's Hospital of New York Presbyterian, New York, NY; 4University of Minnesota Masonic Children's Hospital, Minneapolis, MN; 5Mattel Children’s Hospital, Los Angeles, CA; 6Cleveland Clinic Foundation, Cleveland, OH; 7Naionwide Children's Hospital, Columbus, OH.

  15. AHA 2017 Poster PresentationTuesday, November 14, 1:30pm – 2:45pClinical Section, Science and Technology Hall Kate S. Arbon1, Yuk M. Law1, James K. Kirklin2, Elizabeth Pruitt2, Kenneth O. Schowengerdt3, Timothy M. Hoffman4, Thomas J. L’Ecuyer5, and Steven J. Kindel6 1Seattle Children’s Hospital, Seattle, WA; 2University of Alabama at Birmingham, Birmingham, AL; 3Cardinal Glennon Children's Medical Center, St. Louis, MO; 4University of North Carolina, Chapel Hill, NC; 5University of Virginia Medical Center, Charlottesville, VA; 6Children's Hospital of Wisconsin, Milwaukee, WI

  16. Annual Fall Meeting, November 12, 2017 PHTS Working Groups • Group 1: Immunosuppression Protocols • Marc Richmond, MD, MS • Group 2: Diagnoses of cellular rejection and surveillance  • Daphne Hsu, MD • Group 3: Diagnosis and treatment of CAV • Elfi Pahl, MD

  17. Practice Variation Workgroups Group 1: Immunosuppression Protocols • Proposing revision of Initial Immunosuppression data collection form (Form 3) • Examined era effect of medications

  18. Practice Variation Workgroups Group 2: Diagnosis of Cellular Rejection and Surveillance • Abstract submitted to ISHLT 2018 • Examined center variability within first year and after first year of transplant • Surveillance practices • Diagnosis practices • Recipient age related practices • Preparing manuscript

  19. Practice Variation Workgroups Group 3: Diagnosis and Treatment of CAV • Abstract submitted to ISHLT 2018 • Examined center variability for coronary evaluation methods • Surveyed centers about angiography frequency • Preparing protocol guidelines

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