scholarly journals 1390. A Novel Application of the Interferon-Gamma Release Assay (IGRA) Among End-Stage Heart Failure Patients Awaiting Heart Transplantation

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S505-S505
Author(s):  
Ming-Jui Tsai ◽  
Aristine Cheng ◽  
Hsin-Yun Sun ◽  
Yih-Sharng Chen ◽  
Nai-Kuan Chou ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Transplantation ◽  
Interferon Gamma ◽  
Heart Transplant ◽  
Interferon Γ ◽  
Positive Control ◽  
Cell Mediated Immunity ◽  
Release Assay ◽  
Transplant Candidates ◽  
Overall Mortality

Abstract Background The optimal approach to assay the immune status in heart failure is challenging because of the inherent complexity of chronic inflammation. Interferon-gamma release assays (IGRAs) measure an aspect of cell-mediated immunity encompassing both the innate and adaptive immunity. In this study, we evaluated the utility of a commercial IGRA for predicting mortality and infectious complications among heart transplant candidates. Methods This prospective cohort study was conducted between August 1, 2014 and January 31, 2019 at a medical center in Taiwan. All heart transplant candidates received an IGRA (QuantiFERON®-TB Gold In-Tube, QFT-GIT) at baseline as part of the initiative to screen for latent tuberculosis. Impaired cell-mediated immunity was defined as the release of <1 IU/mL of interferon-γ (IFN-γ) in response to the common mitogen in the positive control tube.The patients were then followed until death or January 31, 2019. Results A total of 102 patients were enrolled; of whom, 23 (22.5%) had impaired cell-mediated immunity at baseline. During the study period with a median follow-up of 1.90 years (IQR 1.17–3.56), 23 (22.5%) patients died and 45 (44.1%) patients developed an infectious complication. Overall mortality was significantly greater among those with impaired cell-mediated immunity [39.1% (9/23) vs. 17.7% (14/79), P = 0.031]. A trend toward higher rates of infection was observed among impaired cell-mediated immunity group [60.9% (14/23) vs. 39.2% (31/79), P = 0.066]. The most common cause of death was infection (56.5%). No patient developed active tuberculosis during the study and the most common infection was bacteremia (35.6%). In the age-adjusted multivariate analysis, impaired cell-mediated immunity was an independent predictor of mortality (HR 2.87, CI 1.23–6.68, P = 0.014) and subsequent infectious event (HR 3.00, CI 1.56–5.76, P = 0.001). Conclusion An interferon-γ release assay utilizing the positive control tube of the QuantiFERON®-TB Gold In-Tube kit was predictive of overall mortality and infections among patients with advanced heart failure awaiting heart transplantation. Disclosures All authors: No reported disclosures.

scholarly journals A 6-YEAR EXPERIENCE OF HEART TRANSPLANTATION IN FEDERAL ALMAZOV NORTH-WEST MEDICAL RESEARCH CENTRE

2017 ◽  
Vol 18 (4) ◽  
pp. 33-42 ◽  
Author(s):  
E. V. Shlyakhto ◽  
M. L. Gordeev ◽  
M. A. Karpenko ◽  
G. V. Nikolaev ◽  
A. S. Gnevashev ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Medical Research ◽  
Heart Transplant ◽  
Graft Loss ◽  
Research Centre ◽  
Tricuspid Valve Repair ◽  
North West ◽  
Transplant Candidates ◽  
Batista Procedure ◽  
High Level

Aim. To estimate the results of 6-year experience of heart transplantation (HT) in Federal Almazov North-West Medical Research Centre. Methods. From 2010 to 2015 we have performed 65 HT. Mean age was 44.3 ± 14 years old (from 10 to 64 years old). We used biventricular assist device (BIVAD, Berlin Heart Excor) support in 7 heart transplant candidates before HT. 19 patients (29%) received thymoglobulin, whereas 46 patients (71%) had basiliximab to induce immunosuppression.Results.Extracorporeal membrane oxygenation machines were implanted in 5 patients (7.7%) after HT due to acute right ventricular failure. Suture annuloplasty (the Batista procedure) for tricuspid valve repair was carried out in 3 cases (4.6%). Venovenous hemodiafi ltration was used in 11 patients (16.9%). A total of 598 endomyocardial biopsies (EMB) were performed after HT. Evidence of cellular rejection (R1 and R2) was presented in 286 biopsies (48%). The 30-day in-hospital mortality rate was 3.1%. The 6-month survival rate after HT was 92%, 1-year – 91% and overall survival for the 6-year period of observation – 89.2%. Maximum observation period was 71 months.Conclusions.The 6-year experience of HT in our Center has shown a high level of survival. BIVAD Excor support can be effectively used as a «bridge» to HT. Prevention of graft loss due to acute rejection in heart transplant recipients can be achieved only through regular EMB monitoring. The rate of viral infection increased in 2 months after HT.

scholarly journals Impact of Heart Transplantation on Cheyne-Stokes Respiration in a Child

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Suhail Al-Saleh ◽  
Paul F. Kantor ◽  
Indra Narang
Keyword(s):  
Heart Failure ◽  
Heart Transplantation ◽  
Dilated Cardiomyopathy ◽  
Heart Transplant ◽  
Cardiac Transplantation ◽  
Sleep Disordered Breathing ◽  
Pediatric Population ◽  
Severe Heart Failure ◽  
Advanced Heart Failure ◽  
Caucasian Male

Sleep disordered breathing is well described in adults with heart failure but not in pediatric population. We describe a 13-year-old Caucasian male with severe heart failure related to dilated cardiomyopathy who demonstrated polysomnographic features of Cheyne-Stokes respiration, which completely resolved following cardiac transplantation. Cheyne-Stokes respiration in children with advanced heart failure and its resolution after heart transplant can be observed similar to adults.

scholarly journals The Distribution Frequency of Interferon-Gamma Receptor 1 Gene Polymorphisms in Interferon-γ Release Assay-Positive Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Changguo Chen ◽  
Lei Chen ◽  
Changwei Chen ◽  
Qiuyuan Chen ◽  
Qiangyuan Zhao ◽  
...  
Keyword(s):  
Interferon Gamma ◽  
Promoter Region ◽  
Gene Polymorphisms ◽  
Statistical Significance ◽  
Interferon Γ ◽  
Mutation Rates ◽  
Gamma Receptor ◽  
Release Assay ◽  
Positive Groups ◽  
Distribution Frequency

Tuberculosis is caused by mycobacterium, a potentially fatal infectious bacterium. In recent years, TB cases increased in the whole world. WHO statistics data shows that the world’s annual tuberculosis incidence was 8~10 million with about 3 million deaths. Several studies have shown that susceptibility to tuberculosis may be associated with IFNGR1 gene polymorphisms. Here, we report the distribution frequency of IFNGR1 gene polymorphisms in 103 cases of IGA-negative patients and 100 cases of IGA-positive patients from China by sequencing the IFNGR1 proximal ~750 bp promoter region. We found a total of 5 types of site mutations: -611 (G/A), -56 (T/C), -255 (C/T), -359 (T/C), and -72 (C/T). The two main types of gene polymorphisms among the IGA-negative and IGA-positive groups were -611 (G/A), with mutation rates of 88.3% and 78.4%, respectively, and -56 (T/C), with mutation rates of 84.5% and 83.8%, respectively, which had no statistical significance, and there was no correlation with the incidence of tuberculosis.

Heart Transplantation

2014 ◽  
Author(s):  
Michael M. Givertz
Keyword(s):  
Heart Failure ◽  
Heart Transplantation ◽  
Heart Transplant ◽  
Cardiac Allograft Vasculopathy ◽  
Cardiac Allograft ◽  
Transplant Recipients ◽  
Allograft Vasculopathy ◽  
Adult Heart ◽  
Heart Transplantations ◽  
Heart Transplant Recipients

Heart failure is a major public health problem with significant associated morbidity and mortality. Heart transplantation remains the standard of care for highly selected patients with end-stage heart failure and absence of contraindications to transplantation. This chapter discusses indications and contraindications for transplantation; recipient evaluation, selection, and management; donor selection; timing of the procedure and surgical technique; medical management, including immunosuppression, prevention and treatment of infections, and other standard or preventive therapy; late complications; and functional status and long-term survival. Tables describe patient referral to a specialized center for heart transplantations; guidelines of indications for cardiac transplantation; organ dysfunction; pretransplantation evaluation; waiting lists; therapeutic options for patients with advanced or refractory heart failure; treating highly sensitized patients; suggested vaccinations; guidelines for donor hearts with severe infection; high-risk donor behavior; hemodynamic effect of commonly used parenteral agents; frequency of follow-up evaluations; revised International Society for Heart and Lung Transplantation (ISHLT) formulation for diagnosis of cardiac allograft rejection and suggested treatment; function of immunosuppressive agents; administration, dosing, monitoring, and adverse effects of commonly used immunosuppressants; common agents that interfere with tacrolimus and cyclosporine; cytomegalovirus prophylaxis and valganciclovir based on estimated renal function; cumulative morbidity rates in adult heart transplant survivors; and therapies to prevent and treat osteoporosis posttransplantation. Figures depict the progression of heart failure; change in functional status over time in patients with chronic heart failure; US heart transplantations in 2012; percentage of US adult wait-listed patients who received a donor heart transplant within a year and donation rates by state; bicaval surgical technique; endomyocardial biopsies; timeline of infection following solid-organ transplantation; cardiac allograft vasculopathy; and squamous cell carcinomas in a heart transplant patient. Graphs show adult worldwide heart transplantation volume from 1982 to 2010; changing characteristics of US adult heart transplant recipients; relative risk of death and development of cardiac allograft vasculopathy; posttransplantation immunosuppression at 1 and 5 years in the ISHLT Registry; older donor age and risk of developing cardiac allograft vasculopathy; freedom from malignancy in the ISHLT Registry; employment status of adult heart transplant recipients; adult heart transplant survival; and patient survival among US heart transplant recipients by gender and race. This review contains 18 highly rendered figures, 20 tables, and 109 references.

scholarly journals Performance of a Whole-Blood Interferon-Gamma Release Assay withMycobacteriumRD1-Specific Antigens among HIV-Infected Persons

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Akira Fujita ◽  
Atsushi Ajisawa ◽  
Nobuyuki Harada ◽  
Kazue Higuchi ◽  
Toru Mori
Keyword(s):  
Interferon Gamma ◽  
High Sensitivity ◽  
Positive Control ◽  
Interferon Gamma Release Assay ◽  
Cell Counts ◽  
Positive Rate ◽  
Release Assay ◽  
Specific Antigens ◽  
Proportional Relationship ◽  
Interferon Gamma Response

Objective. To evaluate the usefulness of one of IGRAs, QuantiFERON-TB Gold (QFT-G), in human immunodeficiency virus- (HIV- ) infected patients with variousCD4+T cell counts.Methods. The QFT-G assay was performed using QFT-G kits among 107 HIV-infected patients including 9 cases with active tuberculosis (TB).Results. In HIV-infected patients withCD4+>50/μL, QFT-G positive rate for active TB patients was 5/6 (sensitivity=83%), and that for those without active disease was 1/69 (specificity=99%). The frequency of indeterminate QFT-G test was significantly higher in those withCD4+less than50/μL(P<.0001). At the same time there was a proportional relationship betweenCD4+and interferon-gamma response to mitogen (positive control) in QFT-G test (P=.0001).Conclusions. Our data suggested that QFT-G had high sensitivity and specificity in HIV-infected populations withCD4+greater than50/μL. However, QFT-G did not perform well in HIV-positive patients withCD4+less than50/μL.

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