Suppression of panel-reactive antibodies by treatment with mycophenolate mofetil.
"Panel Reactive Antibody" (PRA) testing is commonly used to assess the pretransplant antibody status in order to estimate the risk of an adverse humoral response following transplantation. We report on a female patient with end-stage cardiac failure suffering from acute myocarditis who underwent implantation of a left-ventricular assist device (Novacor, Baxter Healthcare Corp. Oakland, CA). During evaluation for heart transplantation, a PRA level of 50-70% was detected. After treatment with mycophenolate mofetil at a dosage of 2 g daily, PRA levels declined within one week to 0-5%, and remained low after discontinuation of the immunosuppressive drug. We feel that pretreatment of patients with elevated PRA levels with mycophenolate mofetil is well justified.
Department of Cardiothoracic Surgery, Westphalian Wilhelms University, Münster, Germany.
C
C
Schmid
H S
HS
Garritsen
R
R
Kelsch
U
U
Cassens
H A
HA
Baba
W
W
Sibrowski
H H
HH
Scheld
D000208:Acute Disease; D000328:Adult; D000911:Antibodies, Monoclonal / Q000032:analysis / Q000187:drug effects*; D000917:Antibody Formation / Q000187:drug effects; D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology / Q000601:surgery*; D016027:Heart Transplantation / Q000276:immunology*; D006353:Heart-Assist Devices / Q000009:adverse effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*; D009205:Myocarditis / Q000150:complications; D011300:Preoperative Care; D013924:Thrombophlebitis / Q000188:drug therapy / Q000209:etiology
D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid