Heart transplantation in a highly sensitised patient.
Some patients awaiting heart transplantation may develop positive panel reactive antibodies (PRA). Several reports have demonstrated that pre-transplant sensitisation is associated with decreased survival and a higher rejection rate, and leads to the development of cardiac allograft vasculopathy. We describe our experience with a highly sensitised transplant recipient. To reduce sensitisation, three courses of immunoadsorption were administered. The PRA level decreased effectively and actual cross-match was negative. The patient underwent successful heart transplantation, and desensitisation treatment continued with immunoadsorption and intravenous immunoglobulin for five courses. Graft function remains normal at 12 months post-operatively and the clinical status of the patient is stable.
1Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. lenka.hoskova@ikem.cz
Lenka
L
Hošková
Libuse
L
Pagáč ová
Antonij
A
Slavč ev
Ludek
L
Voska
Josef
J
Kautzner
D003888:Desensitization, Immunologic / Q000379:methods; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology; D016027:Heart Transplantation / Q000276:immunology*; D006789:Host vs Graft Reaction / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007167:Immunotherapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome
D006680:HLA Antigens; D007166:Immunosuppressive Agents