Sex differences in the incidence of antibody-mediated rejection events after heart transplantation

Nadezdha Koloskova, Vitaly Poptsov, Vyacheslav Zakharevich, Alexey Shevchenko, I Muminov, N Mogeiko, T Khalilulin

Federal State Budgetary Institution “Academician V.I.Shumakov Federal Research Center of Transplantology and Artificial Organs”, Ministry of Health of the Russian Federation, Moscow, Russia

Date, time and location: 2018.05.25 15:30, Exhibition area, 1st Floor. Zone – A

Abstract

Background

Acute antibody-mediated rejection (AMR) is a significant risk factor for poor outcome after organ transplantation Pregnancies may result in antibodies against HLA, a risk factor for antibody-mediated rejection after heart transplantation (HTx). The aim of this study was to evaluate sex differences in the incidence of AMR events after heart transplantation.

Methods

The study comprised 606 patients (84 [14%] women) who underwent HTx in 2010 to 2017.We examined the incidence of AMR episodes in patients transplanted 2010 and 2017. The cumulative effect of AMR events was calculated by AMR score (sum of myocardial biopsy grading divided by number of biopsies taken during 3 years post-HTx).

Results

Women demonstrated a significant increase in the total incidence of AMR events (32% vs. 9%), compared to men (P < 0.05). From 27 women with AMR 7 (46,6%)

had pregnancy historybefore HTx/Females had higher levels of antibody-mediated rejection which was associated with a history of pregnancies. There were no differences in cellular rejection between the groups.

Conclusions

Female sex has been shown to be a risk factor for rejection post-HTx. Females recipients may benefit from closer surveillance to identify AMR at an earlier stage post-HTxcompared with men. Women are at higher risk for allosensitizationwas associated with a history of pregnanciesbefore HTx which is associated with higher incidence of AMR post-HTx compared with men.