Possible Link Between the ABO Blood Group of Bioprosthesis Recipients and Specific Types of Structural Degeneration
Open Access
- 4 August 2020
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of the American Heart Association
- Vol. 9 (15)
- https://doi.org/10.1161/JAHA.119.015909
Abstract
Background Pigs/bovines share common antigens with humans: alpha -Gal, present in all pigs/bovines close to the human B-antigen; and AH-histo-blood-group antigen, identical to human AH-antigen and present only in some animals. We investigate the possible impact of patients' ABO blood group on bioprosthesis structural valve degeneration (SVD) through calcification/pannus/tears/perforations for patients <= 60 years at implantation. Methods and Results This was a single-center study (Paris, France) that included all degenerative bioprostheses explanted between 1985 and 1998, mostly porcine bioprostheses (Carpentier-Edwards second/third porcine bioprostheses) and some bovine bioprostheses. For the period 1998 to 2014, only porcine bioprostheses with longevity >= 13 years were included (total follow-up >= 29 years). Except for blood groups, important predictive factors for SVD were prospectively collected (age at implantation/longevity/number/site/sex/SVD types) and analyzed using logistic regression. All variables were available for 500 explanted porcine bioprostheses. By multivariate analyses, the A group was associated with an increased risk of: tears (odds ratio[OR], 1.61; P=0.026); pannus (OR, 1.5; P=0.054), pannus with tears (OR, 1.73; P=0.037), and tendency for lower risk of: calcifications (OR, 0.63; P=0.087) or isolated calcification (OR, 0.67; P=0.17). A-antigen was associated with lower risk of perforations (OR 0.56; P=0.087). B-group patients had an increased risk of: perforations (OR, 1.73; P=0.043); having a pannus that was calcified (OR, 3.0, P=0.025). B-antigen was associated with a propensity for calcifications in general (OR, 1.34; P=0.25). Conclusions Patient's ABO blood group is associated with specific SVD types. We hypothesize that carbohydrate antigens, which may or may not be common to patient and animal bioprosthetic tissue, will determine a patient's specific immunoreactivity with respect to xenograft tissue and thus bioprosthesis outcome in terms of SVD.This publication has 106 references indexed in Scilit:
- Effect of the αGal Epitope on the Response to Small Intestinal Submucosa Extracellular Matrix in a Nonhuman Primate ModelTissue Engineering, Part A, 2009
- Structural biology of carbohydrate xenoantigensExpert Opinion on Biological Therapy, 2009
- Widespread Gene Conversion of Alpha-2-Fucosyltransferase Genes in MammalsJournal of Molecular Evolution, 2009
- Immune response to biologic scaffold materialsSeminars in Immunology, 2008
- The Emerging Role of Valve Interstitial Cell Phenotypes in Regulating Heart Valve PathobiologyThe American Journal of Pathology, 2007
- ABO blood group and related antigens, natural antibodies and transplantationTissue Antigens, 2006
- Letter to the EditorXenotransplantation, 2004
- Influence of Glutaraldehyde Fixation on the Detection of SLA-I and II Antigens and Calcification Tendency in Porcine Cardiac TissueScandinavian Cardiovascular Journal, 2000
- Monomorphic and polymorphic carbohydrate antigens on pig tissues: implications for organ xenotransplantation in the pig-to-human modelTransplant International, 1994
- Calcific degeneration as the main cause of porcine bioprosthetic valve failureThe American Journal of Cardiology, 1984