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Applications and limitations of histocompatibility in clinical cardiac valve allograft surgery

  • Magdi Yacoub

Abstract

During the last few years there has been a vast accumulation of knowledge with regard to allograft rejection mechanisms accompanied with development of powerful tools for studying this problem. In addition there has been an accumulation of data specifically related to the homograft valve. The question, therefore, is: Do we know enough to-day to make firm recommendations with regard to clinical practice? In this chapter I shall try and review some of the evidence in an attempt to answer the following questions:
  1. 1.

    Does rejection play a role in determining the fate of aortic valve homografts?

     
  2. 2.

    If so, is it cell- or antibody-mediated?

     
  3. 3.

    Can we modify the process of rejection?

     
  4. 4.

    Are we really justified to use immune suppression on the current evidence we have?

     

Keywords

Histocompatibility Antigen Cardiac Transplant Recipient Aortic Homograft Homograft Valve Fresh Homograft 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Rose ML, Coles MI, Griffin RJ, Pomerance A, Yacoub MH (1986) Expression of Class I and Class II major histocompatibility antigens in normal and transplanted hearts. Transplantation 41, 776–780PubMedCrossRefGoogle Scholar
  2. 2.
    Suitters A, Rose M, Higgins A, Yacoub MH (1987) MHC antigen expression in segmental biopsies from cardiac transplant patients — correlation with rejection. Clin. Exp. Immunol. 69, 575–583PubMedGoogle Scholar
  3. 3.
    Yacoub M, Suitters A, Khaghani A, Rose M (1986) Localisation of major histocompatibility complex (HLA ABC and DR) antigens in aortic homografts. In: Bodner E, Yacoub M (eds) Biologic and Bioprosthetic Valves. Yorke Medical BooksGoogle Scholar
  4. 4.
    Yacoub MH, Festenstein P, Doyle M, Martin D, McClusky D, Awad J, Gamka A, Khaghani A, Holmes A (1987) The influence of HLA matching in cardiac allograft recipients receiving cyclosporin and azathioprine. Transpl Proc 19, 2487Google Scholar

Copyright information

© Dr. Dietrich Steinkopff Verlag GmbH & Co. KG, Darmstadt 1988

Authors and Affiliations

  • Magdi Yacoub
    • 1
    • 2
  1. 1.Consultant Cardiac SurgeonHarefield HospitalHarefield, Uxbridge, MiddlesexUK
  2. 2.National Heart and Brompton HospitalLondonUK

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