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Han J, Rushakoff J, Moayedi Y, Henricksen E, Lee R, Luikart H, Shalakhti O, Gragert L, Benck L, Malinoski D, Kobashigawa J, Teuteberg J, Khush KK, Patel J, Kransdorf E. HLA sensitization is associated with an increased risk of primary graft dysfunction after heart transplantation. J Heart Lung Transplant 2024; 43:387-393. [PMID: 37802261 DOI: 10.1016/j.healun.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 08/30/2023] [Accepted: 09/24/2023] [Indexed: 10/08/2023] Open
Abstract
Primary graft dysfunction (PGD) is a leading cause of early morbidity and mortality following heart transplantation (HT). We sought to determine the association between pretransplant human leukocyte antigen (HLA) sensitization, as measured using the calculated panel reactive antibody (cPRA) value, and the risk of PGD. METHODS Consecutive adult HT recipients (n = 596) from 1/2015 to 12/2019 at 2 US centers were included. Severity of PGD was based on the 2014 International Society for Heart and Lung Transplantation consensus statement. For each recipient, unacceptable HLA antigens were obtained and locus-specific cPRA (cPRA-LS) and pre-HT donor-specific antibodies (DSA) were assessed. RESULTS Univariable logistic modeling showed that peak cPRA-LS for all loci and HLA-A was associated with increased severity of PGD as an ordinal variable (all loci: OR 1.78, 95% CI: 1.01-1.14, p = 0.025, HLA-A: OR 1.14, 95% CI: 1.03-1.26, p = 0.011). Multivariable analysis showed peak cPRA-LS for HLA-A, recipient beta-blocker use, total ischemic time, donor age, prior cardiac surgery, and United Network for Organ Sharing status 1 or 2 were associated with increased severity of PGD. The presence of DSA to HLA-B was associated with trend toward increased risk of mild-to-moderate PGD (OR 2.56, 95% CI: 0.99-6.63, p = 0.053), but DSA to other HLA loci was not associated with PGD. CONCLUSIONS Sensitization for all HLA loci, and specifically HLA-A, is associated with an increased severity of PGD. These factors should be included in pre-HT risk stratification to minimize the risk of PGD.
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Affiliation(s)
- Jiho Han
- Section of Cardiology, Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
| | - Josh Rushakoff
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Yasbanoo Moayedi
- Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
| | - Erik Henricksen
- Department of Transplant, Stanford Health Care, Stanford, California
| | - Roy Lee
- Department of Transplant, Stanford Health Care, Stanford, California
| | - Helen Luikart
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, California
| | - Omar Shalakhti
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, California
| | - Loren Gragert
- Department of Pathology, Tulane University School of Medicine, New Orleans, Louisiana
| | - Lillian Benck
- Division of Cardiology, NorthShore University Health System, Chicago, Illinois
| | - Darren Malinoski
- Critical Care and Acute Care Surgery, Oregon Health Sciences University, Portland, Oregon
| | - Jon Kobashigawa
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Jeffrey Teuteberg
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, California
| | - Kiran K Khush
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University, Stanford, California
| | - Jignesh Patel
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Evan Kransdorf
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
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Sampath V, Shalakhti O, Veidis E, Efobi JAI, Shamji MH, Agache I, Skevaki C, Renz H, Nadeau KC. Acute and chronic impacts of heat stress on planetary health. Allergy 2023; 78:2109-2120. [PMID: 36883412 DOI: 10.1111/all.15702] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023]
Abstract
Heat waves are increasing in intensity, frequency, and duration causing significant heat stress in all living organisms. Heat stress has multiple negative effects on plants affecting photosynthesis, respiration, growth, development, and reproduction. It also impacts animals leading to physiological and behavioral alterations, such as reduced caloric intake, increased water intake, and decreased reproduction and growth. In humans, epidemiological studies have shown that heat waves are associated with increased morbidity and mortality. There are many biological effects of heat stress (structural changes, enzyme function disruption, damage through reactive oxygen or nitrogen species). While plants and animals can mitigate some of these effects through adaptive mechanisms such as the generation of heat shock proteins, antioxidants, stress granules, and others, these mechanisms may likely be inadequate with further global warming. This review summarizes the effects of heat stress on plants and animals and the adaptative mechanisms that have evolved to counteract this stress.
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Affiliation(s)
- Vanitha Sampath
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, California, Stanford, USA
| | - Omar Shalakhti
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, California, Stanford, USA
| | - Erika Veidis
- Center for Innovation in Global Health, Stanford University, California, Stanford, USA
| | - Jo Ann Ifeoma Efobi
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, California, Stanford, USA
| | - Mohamed H Shamji
- National Heart and Lung Institute, Imperial College London, London, UK
- NIHR Imperial Biomedical Research Centre, London, UK
| | - Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Chrysanthi Skevaki
- Institute of Laboratory Medicine, Member of the German Center for Lung Research (DZL), Philipps-University Marburg, Marburg, Germany
- German Center for Lung Research (DZL), Universities of Giessen and Marburg Lung Center (UGMLC), Philipps University Marburg, Marburg, Germany
| | - Harald Renz
- Institute of Laboratory Medicine, Member of the German Center for Lung Research (DZL), Philipps-University Marburg, Marburg, Germany
- German Center for Lung Research (DZL), Universities of Giessen and Marburg Lung Center (UGMLC), Philipps University Marburg, Marburg, Germany
- Department of Clinical Immunology and Allergology, Sechenov University, Moscow, Russia
- Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
| | - Kari C Nadeau
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Ojeda VD, Magana C, Shalakhti O, Vargas-Ojeda AC, Burgos JL. Tattoo discrimination in Mexico motivates interest in tattoo removal among structurally vulnerable adults. Front Public Health 2022; 10:894486. [PMID: 36062106 PMCID: PMC9433543 DOI: 10.3389/fpubh.2022.894486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/11/2022] [Indexed: 01/22/2023] Open
Abstract
Tattoos are less prevalent in Mexico and tattooed persons are frequently stigmatized. We examine the prevalence and correlates of interest in receiving tattoo removal services among 278 tattooed Mexican adults living in Tijuana, Mexico who responded to interviewer-administered surveys, including open-ended questions. Overall, 69% of participants were interested in receiving free tattoo removal services, 31% reported facing employment barriers due to their tattoos, and 43% of respondents regretted or disliked some of their tattoos. Having a voter identification card, reporting moderate/severe depression symptoms and believing that tattoo removal would remove employment barriers were independently associated with interest in tattoo removal. Our findings suggest that there is substantial interest in tattoo removal services. Publicly financed tattoo removal services may help disadvantaged persons gain access to Mexico's labor market and it may positively impact other life domains such as mental well-being and interactions with law enforcement.
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Affiliation(s)
- Victoria D. Ojeda
- Herbert Wertheim School of Public Health, University of California, San Diego, San Diego, CA, United States,Department of Medicine, School of Medicine, University of California, San Diego, San Diego, CA, United States,*Correspondence: Victoria D. Ojeda
| | - Christopher Magana
- Herbert Wertheim School of Public Health, University of California, San Diego, San Diego, CA, United States
| | - Omar Shalakhti
- Herbert Wertheim School of Public Health, University of California, San Diego, San Diego, CA, United States
| | | | - Jose Luis Burgos
- Herbert Wertheim School of Public Health, University of California, San Diego, San Diego, CA, United States
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Han J, Kransdorf E, Rushakoff J, Moayedi Y, Henricksen E, Lee R, Luikart H, Shalakhti O, Benck L, Malinoski D, Kobashigawa J, Teuteberg J, Khush K, Patel J. Spontaneous Donor Hypothermia is Independently Associated with Increased Risk of Primary Graft Dysfunction After Heart Transplant. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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