The Hypothesis of the Interplay Between Air Particulate Matter PM2.5 and Acute Cellular Rejection Episodes Following Heart Transplantation
Background: In end-stage HF, interventional therapy is the treatment of choice, including mechanical circulatory support and heart organ transplantation. Acute cellular rejection is considered a major impediment to the long-term survival of cardiac allografts. The aim of this study is to point out a...
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| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-02-01
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| Series: | Atmosphere |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2073-4433/16/2/234 |
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| Summary: | Background: In end-stage HF, interventional therapy is the treatment of choice, including mechanical circulatory support and heart organ transplantation. Acute cellular rejection is considered a major impediment to the long-term survival of cardiac allografts. The aim of this study is to point out a possible relationship underlying acute cellular rejection risk in heart organ recipients. Methods: A total of 30 (25 (83%) men and 5 (17%) women) heart organ recipients with a median (Q1–Q3) age of 49 (38–60) were enrolled in the analysis. The results from repeated hospitalizations due to protocolar endomyocardial biopsies performed between one and three months following the heart transplantation in relation air pollution exposure were taken into the analysis. Results: The median (Q1–Q3) observation time after organ transplantation was 92 (82–97) days. A significant difference in PM2.5 exposure between the rejection group (16.10 (14.24–17.61)) μg/m<sup>3</sup> and the non-rejection group (11.97 (9.85–12.97)) μg/m<sup>3</sup> was noticed (<i>p</i> < 0.001). The odds ratio (95% confidence interval) for acute rejection prediction related to PM2.5 was 1.79 (1.11–2.89), <i>p</i> = 0.018. The reviewer operator curve for acute cellular rejection related to PM2.5 exposure was performed, and the area under the curve (AUC) was 0.873, yielding a precision of 0.600 and an f-measure of 0.545. The predicted residual plots for PM2.5 indicated a 50% increased risk for PM2.5 above 16 μg/m<sup>3</sup> and of 91% for PM2.5 above 20 μg/m<sup>3</sup>. Conclusions: The single-center study was performed on a limited number of heart organ recipients and was related to personalized individual calculations of PM2.5 exposure. The study represents a personalized approach and indicates possible links to the hypothesis, which should be verified on a higher volume of patients. |
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| ISSN: | 2073-4433 |