title: Safety and Efficacy of Immunoadsorption in Heart Transplantation Program.
abstract: BACKGROUND
  Antibody-mediated rejection (AMR) is a serious complication of organ transplantation, and its treatment is complex. The aim of this study was to assess immunoadsorption (IA) for treatment-immunized patients before heart transplantation (HTX) and as the first step of AMR treatment after HTX.
  
  
  METHODS
  The cohort consisted of 10 patients (8 men, 2 women; age range, 20-57 years). For 3 of these patients, IA was included in the desensitization protocol before HTX; for 7 patients, IA was the first step of the treatment protocol. One patient underwent IA before and after HTX.
  
  
  RESULTS
  A comparison of values before IA and after the last procedure showed a decrease in immunoglobulin subgroups (G, M, and A). In patients before HTX, a decline was noted in panel reactive antibodies. After HTX, IA procedures led to a significant decrease in donor-specific antibody (DSA) class I; DSA class II fell in 6 of 7 patients, with 51% falling below the detection limit.
  
  
  CONCLUSIONS
  IA in patients during HTX is safe procedure for reducing DSA. The removal of antibodies is the first step in comprehensive treatment and must be followed by a procedure that prevents their further development.
authors: Cardiovascular Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. Electronic address: tomas.gazdic@ikem.cz.
authors: T
authors: T
authors: Gazdic
authors: Cardiology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors: I
authors: I
authors: Malek
authors: Hematology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors: L
authors: L
authors: Pagacova
authors: Immunogenetics Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors: A
authors: A
authors: Slavcev
authors: Clinical and Transplant Pathology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors: L
authors: L
authors: Voska
authors: Cardiology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors: M
authors: M
authors: Hegarova
authors: Cardiology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors: L
authors: L
authors: Hoskova
authors: Cardiology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors: M
authors: M
authors: Kubanek
authors: Cardiovascular Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors: J
authors: J
authors: Pirk
mesh_terms: D000293:Adolescent; D000328:Adult; D000906:Antibodies / Q000276:immunology; D003888:Desensitization, Immunologic / Q000379:methods; D005260:Female; D006084:Graft Rejection / Q000276:immunology; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans; D007163:Immunosorbent Techniques; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors; D055815:Young Adult
chemical_list: D000906:Antibodies