M. Bechtel1, A. Marquardt1, M. Müller-Steinhardt2, U. Stierle1, H.-H. Sievers1
Department for Cardiac and Thoracic Vascular Surgery1, University of Luebeck, and the Institute of Transfusion Medicine and Immunology2; Medical Faculty Mannheim, Germany
[Applied Cardiopulmonary Pathophysiology 14: 51-57, 2010]
Objectives: Perioperative temperature has been suggested to be a marker of an immune reaction against allograft valves. We explored whether there is an association between perioperative temperature and pulmonary allograft valve function or the development of anti-HLA antibodies.
Methods: The highest temperature on each of the first five postoperative days was extracted from the records of 211 patients (79% male, mean age 45 ± 14 years) who had had a Ross operation. For further analysis, the area under the temperature curve of each patient was calculated and then tested for correlations with valve function. Two echocardiographic measurements, which were approximately 5 years apart from each other, were analyzed. In a subgroup of 160 and 100 patients, respectively, anti-HLA class I and II antibodies were measured and also tested for an association with perioperative temperature.
Results: After a median of 0.9 years, we observed a weak, but statistically significant correlation between perioperative temperature and the transvalvular pressure gradients (r=0.20, p=0.005). However, there was no such association after a median of 6.1 years, and there was no association with the grade of regurgitation at any time. The development of anti-HLA antibodies also appears not to correlate with perioperative temperature.
Conclusions: This study suggests that there is no important association between the temperature recorded during the first few postoperative days and the function or fate of pulmonary allograft valves or the development of anti-HLA antibodies.
Key words: immunology, rejection, surgery, transplantation, valves
Address for corresponding:
Prof. H. H. Sievers, M.D., Klinik für Herz- und thorakale Gefäßchirurgie, UKSH, Campus Lübeck, Ratzeburger Alle 160, D-23538 Lübeck, Germany