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Characterization of the cellular infiltrate in bioprosthetic heart valves explanted from patients with structural valve deterioration

Characterization of the cellular infiltrate in bioprosthetic heart valves explanted from patients... To the Editor: There is increasing evidence that structural valve deterioration (SVD) of glutaraldehyde‐fixed bioprosthetic heart valves (GBHVs) of porcine or bovine origin is associated with an immune response to the xenograft . In both porcine valves and bovine pericardium‐fashioned valves, SVD involves the thickening and calcification of the GBHV with subsequent narrowing of the valve and/or tearing of the valve cusps. There is increasing evidence that the expression of galactose‐α1, 3‐galactose (Gal) plays a role in the development of SVD and preliminary evidence that N‐glycolylneuraminic acid is another xenoantigen that is a factor . Nevertheless, other factors are almost certainly involved. Using immunohistochemistry techniques, we characterized the cellular infiltrate present in 11 GBHVs that had been explanted from patients with SVD (Table ). The median age of the patients at the time of initial valve implant was 43 yr (range 11‐72 yr), and the median time to valve failure was 12 yr (range 2–20 yr). All 11 explanted valves stained strongly for anti‐human IgM/IgG, but none stained positive for the Gal antigen, suggesting that the Gal antigen had been degraded or had been “masked” by the binding of human anti‐pig antibody. Cellular infiltrate in explanted GBHV Patient http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Xenotransplantation Wiley

Characterization of the cellular infiltrate in bioprosthetic heart valves explanted from patients with structural valve deterioration

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References (19)

Publisher
Wiley
Copyright
© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
ISSN
0908-665X
eISSN
1399-3089
DOI
10.1111/xen.12187
pmid
26315116
Publisher site
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Abstract

To the Editor: There is increasing evidence that structural valve deterioration (SVD) of glutaraldehyde‐fixed bioprosthetic heart valves (GBHVs) of porcine or bovine origin is associated with an immune response to the xenograft . In both porcine valves and bovine pericardium‐fashioned valves, SVD involves the thickening and calcification of the GBHV with subsequent narrowing of the valve and/or tearing of the valve cusps. There is increasing evidence that the expression of galactose‐α1, 3‐galactose (Gal) plays a role in the development of SVD and preliminary evidence that N‐glycolylneuraminic acid is another xenoantigen that is a factor . Nevertheless, other factors are almost certainly involved. Using immunohistochemistry techniques, we characterized the cellular infiltrate present in 11 GBHVs that had been explanted from patients with SVD (Table ). The median age of the patients at the time of initial valve implant was 43 yr (range 11‐72 yr), and the median time to valve failure was 12 yr (range 2–20 yr). All 11 explanted valves stained strongly for anti‐human IgM/IgG, but none stained positive for the Gal antigen, suggesting that the Gal antigen had been degraded or had been “masked” by the binding of human anti‐pig antibody. Cellular infiltrate in explanted GBHV Patient

Journal

Xenotransplantation – Wiley

Published: Sep 1, 2015

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