title: Profound hyperacute cardiac allograft rejection rescue with biventricular mechanical circulatory support and plasmapheresis, intravenous immunoglobulin, and rituximab therapy.
abstract: Hyperacute rejection is a rare but potentially catastrophic complication after cardiac transplantation. We describe an unusual case of hyperacute rejection due to preformed anti-donor antibodies despite a negative preoperative panel-reactive antibody (PRA) screen. An excellent outcome was achieved in this case and our strategy involving the use of CentriMag ventricular assist devices (VADs) for biventricular support during treatment with rituximab, intravenous immunoglobulin (IVIG), and plasmapheresis is illustrated.
authors.affiliation: Division of Cardiovascular Surgery, University of Pennsylvania, 3400 Spruce Street, 6 Silverstein Pavilion, Philadelphia, PA 19104, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Kaczorowski
authors.forename: Jashodeep
authors.initials: J
authors.lastname: Datta
authors.forename: Malek
authors.initials: M
authors.lastname: Kamoun
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Dries
authors.forename: Y Joseph
authors.initials: YJ
authors.lastname: Woo
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D006084:Graft Rejection / Q000276:immunology / Q000628:therapy*; D016027:Heart Transplantation / Q000009:adverse effects*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008297:Male; D010956:Plasmapheresis; D000069283:Rituximab; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D016756:Immunoglobulins, Intravenous; D000069283:Rituximab