Changes in the methodology of pre‐heart transplant human leukocyte antibody assessment: an analysis of the United Network for Organ Sharing database

O’Connor, Matthew J.; Keeshan, Britton; Lin, Kimberly Y.; Monos, Dimitrios; Lind, Curt; Paridon, Stephen M.; Mascio, Christopher E.; Shaddy, Robert E.; Rossano, Joseph W.

doi:10.1111/ctr.12590

Cited by 10 publications

(8 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The prevalence of allosensitization in heart transplant candidates increased with the introduction of SPA for screening for HLA antibodies ( 11 ) (Table 1 ). Nevertheless, the risk for poor GS has remained a significant finding even in the more sensitive SPA testing era ( 11 , 12 ). The presence of non-cytotoxic HLA antibodies identified by SAB was associated with high risk of death, early graft failure, and late cellular- and antibody-mediated rejection; these findings underscore the need for using sensitive Luminex platform SPA to accurately determine the presence of circulating HLA antibodies ( 12 ).…”

Section: Adult Htmentioning

confidence: 99%

“…Nevertheless, the risk for poor GS has remained a significant finding even in the more sensitive SPA testing era ( 11 , 12 ). The presence of non-cytotoxic HLA antibodies identified by SAB was associated with high risk of death, early graft failure, and late cellular- and antibody-mediated rejection; these findings underscore the need for using sensitive Luminex platform SPA to accurately determine the presence of circulating HLA antibodies ( 12 ). Detection of Class I DSA pretransplant was a predictor of short-term but not long-term survival as compared to non-DSA ( 13 ).…”

Section: Adult Htmentioning

confidence: 99%

See 1 more Smart Citation

Significance of Anti-HLA Antibodies on Adult and Pediatric Heart Allograft Outcomes

et al. 2017

View full text Add to dashboard Cite

As methods for human leukocyte antigens (HLA) antibody detection have evolved and newer solid phase assays are much more sensitive, the last 15 years has seen a renewed focus on the importance of HLA antibodies in solid organ transplant rejection. However, there is still much controversy regarding the clinical significance of antibody level as depicted by the mean fluorescence intensity of a patient’s neat serum. Emerging techniques, including those that identify antibody level and function, show promise for the detection of individuals at risk of allograft rejection, determination of the effectiveness of desensitization prior to transplant, and for monitoring treatment of rejection. Here, we review current publications regarding the relevance of donor-specific HLA antibodies (DSA) in adult and pediatric heart transplantation (HT) with graft survival, development of antibody-mediated rejection and cardiac allograft vasculopathy (CAV). The negative impact of DSA on patient and allograft survival is evident in adult and pediatric HT recipients. Many questions remain regarding the most appropriate frequency of assessment of pre- and posttransplant DSA as well as the phenotype of DSA memory vs. true de novo antibody using large multicenter adult and pediatric cohorts and state-of-the-art methodologies for DSA detection and characterization.

show abstract

Section: Adult Htmentioning

confidence: 99%

Section: Adult Htmentioning

confidence: 99%

Significance of Anti-HLA Antibodies on Adult and Pediatric Heart Allograft Outcomes

et al. 2017

View full text Add to dashboard Cite

show abstract

“…2 A major impact of sensitization is that it decreases the size of the compatible donor pool and therefore increases wait time to transplant. 6 5 The incidence of this problem is growing with a greater number of heart transplant recipients having evidence of sensitization over the past decade.…”

Section: Introductionmentioning

confidence: 99%

“…5 The incidence of this problem is growing with a greater number of heart transplant recipients having evidence of sensitization over the past decade. 6…”

Section: Introductionmentioning

confidence: 99%

Desensitization in heart transplant recipients: Who, when, and how

Shah

Patel

2019

Clinical Transplantation

View full text Add to dashboard Cite

The number of heart transplant candidates who have pre-formed antibodies against human leukocyte antigens (HLAs) is increasing over time. The purpose of this review is to discuss the process of antibody desensitization for heart transplant candidates. Specifically, we review the current status of antibody detection including identification, strength, and potential pathogenicity. We discuss which patients and when should they undergo desensitization therapies during heart transplant evaluation. Specific therapies including mechanical removal of antibodies, intravenous immunoglobulins, and novel immunosuppressive agents targeting antibody production will be discussed. Finally, future research strategies to develop novel desensitization therapies for heart transplant candidates will be reviewed. K E Y W O R D Sdesensitization, heart disease, sensitization

show abstract

“…M.J. O'Connor, B.C. Keeshan и другие описывают неблагоприятное влияние на прогноз не-ДСА, их связь с высоким риском смерти и поздним клеточным и гуморальным отторжением [15].…”

Section: Introductionunclassified

Criteria for diagnosis of humoral rejection using the method of 2D-speckle-tracking echocardiography

Тхатль

Ставенчук

Космачева

et al. 2019

RJTAO

View full text Add to dashboard Cite

Aim: to identify predictors of humoral rejection at different stages using non-invasive methods of 2D-speckletracking echocardiography, to determine the correlation with immunological changes.Materials and methods. The study was conducted on the basis of Regional Clinic Hospital of Krasnodar from 2010 to 2017. The analysis of 181 heart recipients was performed. 5 groups were allocated due to the crisis of humoral rejection and the identified antibodies to donor leukocyte antigens (HLA antibodies): group 1 (n = 10) – DSA and humoral rejection, group 2 (n = 7), patients with non-DSA and humoral rejection, group 3 (n = 17) – patients with antibodies to HLA, no humoral rejection, group 4 (n = 11), humoral crisis of rejection, with no identified HLA antibodies, group 5 (n = 87) – patients do not have antibodies to HLA and signs of both humoral and cellular rejection according to EMB. Recipients were carried out endomyocardial biopsy, immunological study, 2D-speckle-tracking echocardiography, statistical methods.Results. The diagnostic criteria for a humoral rejection is greater than 1 degree are global peak systolic strain or strain rate of left ventricle (GLPSLV) – 9.94 ± 1.37% (the sensitivity was 86.2%, specificity – 90.4%); radial systolic strain (RadSLV) of 19.36 ± 3.66% (sensitivity was 75.8%, specificity – 84.5%); circumferential systolic strain (CiRSLV) – 17.83 ± 4.79% (sensitivity was 78.6%, specificity – 84.4%); the twisting of the left ventricle (twist) – 8.90 ± 1.85% (sensitivity – 66.7%, specificity – 94.2%), p < 0.001. When considering indicators GLPSLV and longitudinal peak strain of the right ventricle (GLPSRV) in the diagnosis of humoral rejection sensitivity increases to 91.9%, specificity increases to 94.6%, p < 0.001.Conclusion. GLPSLV has greater sensitivity at the stage of subclinical changes. It is more significantly reduced with increasing degree of rejection associated with episodes of rejection in comparison with other parameters and deformation mechanics. The interrelation between histological and immunological changes and impaired myocardial deformation. The proposed diagnostic algorithm will predict humoral rejection.

show abstract

Changes in the methodology of pre‐heart transplant human leukocyte antibody assessment: an analysis of the United Network for Organ Sharing database

Cited by 10 publications

References 24 publications

Significance of Anti-HLA Antibodies on Adult and Pediatric Heart Allograft Outcomes

Significance of Anti-HLA Antibodies on Adult and Pediatric Heart Allograft Outcomes

Desensitization in heart transplant recipients: Who, when, and how

Criteria for diagnosis of humoral rejection using the method of 2D-speckle-tracking echocardiography

Contact Info

Product

Resources

About