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Ann Thorac Surg 2001;71:S396-S400
© 2001 The Society of Thoracic Surgeons

Basic research

Effect of human immunoglobulins on the immunogenicity of porcine bioprostheses

Olivier Schussler, MD, PhDa,b, Ming Shen, MD, PhDa, Lin Shen, MDa, Sophie M. Carpentier, PhDa, Srini Kaveri, PhDb, Alain Carpentier, MD, PhDa

a Laboratoire d’Etude des Greffes et Prothèses Cardiaques, Université de Paris VI, Paris, France
b INSERM U430, Hôpital Broussais, Paris, France

Address reprint requests to Dr Schussler, Laboratoire d’Etude des Greffes et Prothèses Cardiaques, UPRES 264, Hôpital Broussais, 96 rue Didot, 75014 Paris, France
e-mail: labo.legpc{at}brs.ap-hop-paris.fr

Presented at the VIII International Symposium on Cardiac Bioprostheses, Cancun, Mexico, Nov 3–5, 2000.

Background. Glutaraldehyde fixation (GT) is known to reduce immunologic reactions and tissue degeneration after implantation in humans. Sterilization after glutaraldehyde fixation (G-ST) improves the safety and reduces the tendency of GT valves to calcify. Intravenous immunoglobulins (IVIg) have been shown to reduce xenogeneic response against porcine tissue. We have investigated the effect of these fixation procedures combined with and without IVIg on the antigenicity of bioprostheses.

Methods. Lewis adult rats were implanted subcutaneously with a fresh, GT, or G-ST porcine heart valve pre- or posttreated with different amounts of IVIg. We followed by enzyme-linked immunosorbent assay and IgM and IgG titers against protein extracts from the porcine heart valves after implantation. Cellular reactivity was assessed in xenogeneic lymphoendothelial coculture experiments. Calcification content was also examined.

Results. Glutaraldehyde fixation partially decreased the humoral response against proteins of the implant but elicited a cellular xenogeneic response. Sterilization reduced these reactivities, but retained antigenicity. Intravenous immunoglobulin postincubated with GT valves before implantation reduced the antigenicity of the tissue to the same extent as G-ST valves, but had no effect on valvular tissue calcification.

Conclusions. Our studies demonstrate that IVIg or the sterilization procedure (ST) reduced the cellular response against glutaraldehyde-fixed valves (GT), whereas reduced calcification was observed only with ST.






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