Characterisation of antibody responses to Gal-positive and Gal-free biological heart valves

摘要

s / International Journal of Surgery 11 (2013) 563e567 564 ABSTRACTS for patients with pT2 disease for cases with trainee involvement (11 vs. 19 %, p 1⁄4 0.02), although overall margin rates and margin rates for patients with pT3 disease were similar between the groups (p 1⁄4 0.34). Cases involving trainees were longer (241 vs. 200 min, p.001) and resulted in higher estimated blood loss (190 vs. 120 mL, p.001) than the two staff surgeon cases. However, transfusion rates, intraoperative and postoperative complication rates didn,Aot differ significantly between groups. In conclusion, surgical margin rates were lower in teaching cases for patients with pT2 disease. Importantly, trainee involvement in RARP is safe, with similar perioperative outcomes to staff-only surgical cases. This information may be useful for training and surgical planning. CHARACTERISATION OF ANTIBODY RESPONSES TO GAL-POSITIVE AND GAL-FREE BIOLOGICAL HEART VALVES Neha N. Passi, Guerard W. Byrne, Christopher C.G. McGregor Background: Currently used replacement biological heart valves (BHV) contain the major xenoreactive antigen aGal. A clinically relevant, nonhuman primate model has demonstrated a chronic BHV dependent stimulation of anti-Gal antibody in Gal-positive (WT) but not Gal-free (GTKO) BHV recipients. Preliminary flow cytometric analysis has suggested that a non-Gal antibody response to BHVs also exists. This study aimed to confirm these findings by comparing non-Gal antibody responses following implantation of either WT, or GTKO BHVs, in non-human primates. Methods: Immunofluorescence microscopy was used to measure the level of non-Gal IgG antibody binding to GTKO porcine aortic endothelial cells (GTKO-PAECs) and fresh frozen sections of GTKO valves, stained with sera from WT and GTKO BHV recipients, obtained preand post-implantation. Results: An increased level of IgG binding to GTKO-PAECs and GTKO valve sections, following BHV implantation, was present in WT but not in GTKO BHV recipients. Dual staining with CD31 showed non-Gal IgG binding to valve sections was present on endothelial cells on the leaflet surface and non-endothelial cells within the leaflet intima. Conclusions: Gal-positive WT BHVs show increased antigenicity compared to GTKO BHVs, both for antibody reactive to Gal and non-Gal antigens. The increased non-Gal antigenicity of WT BHVs may be due to an aGal dependent adjuvant effect which improves antigenic presentation of Gal associated polypeptides. Preformed and induced antibody mediated responses to BHVs contribute to immune injury, which likely contributes to eventual valve degeneration and calcification. This study provides evidence in support of producing new BHVs using GTKO pig tissue. COMPARISON OF ROBOT-ASSISTED AND LAPAROSCOPIC PELVIC LYMPHADENECTOMY IN PENILE CANCER PATIENTS WITH STAGE N2/ N3 INGUINAL DISEASE James Buxton, Henry Taylor, Gillian Basnett, Raj Nigam, Suks Minhas, John Kelly, Asif Muneer Introduction: Favourable outcomes using robot assisted pelvic lymphadenectomy (RAPL) have been demonstrated in patients with bladder and prostate cancer. Current EAU guidelines recommend ipsilateral pelvic lymphadenectomy for penile cancer patients with metastatic inguinal lymph nodes found at radical inguinal lymphadenectomy. We have compared experience of RAPL and laparoscopic pelvic lymphadenectomy (LPL) for penile cancer patients with N2/N3 disease in a single centre. Methods: Six patients (mean age 61) underwent RAPL and six (mean age 61) underwent LPL. All were penile cancer patients with N2/N3 disease diagnosed at radical inguinal lymphadenectomy. Pelvic lymphadenectomy was performed to the common iliac bifurcation at a separate sitting. Nodal yield, operation time and hospital stay were compared. Results: RAPL and LPL were each performed on 9 pelvic lymph node chains; mean nodal yields (range) were 4.6 (1-10) and 3.1 (0-9) nodes respectively (p1⁄40.33). Mean operation time (range) was 180 (140-225) minutes for RAPL and