Desensitization strategies in the patient awaiting heart transplantation

Chang, D.; Kobashigawa, Jon A.

doi:10.1097/hco.0000000000000389

Cited by 13 publications

(5 citation statements)

References 45 publications

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“…Pretransplant desensitization with TPE can reduce rejection risk by decreasing preformed DSAs to an acceptable threshold of antibody titer . The ideal course is not yet determined—it may involve multiple procedures both before and after the transplantation.…”

Section: Resultsmentioning

confidence: 99%

“…The ideal course is not yet determined—it may involve multiple procedures both before and after the transplantation. Medications involved in the desensitization protocol may include bortezomib, intravenous immune globulin (IVIG), and/or rituximab . TPE can be performed every other day until the goal, such as DSA threshold level for transplant, is met …”

Section: Resultsmentioning

confidence: 99%

“…5 Pretransplant desensitization with TPE can reduce rejection risk by decreasing preformed DSAs to an acceptable threshold of antibody titer. 12 The ideal course is not yet determined-it may involve multiple procedures both before and after the transplantation. Medications involved in the desensitization protocol may include bortezomib, intravenous immune globulin (IVIG), and/or rituximab.…”

Section: Cardiac Transplantationmentioning

confidence: 99%

“…Medications involved in the desensitization protocol may include bortezomib, intravenous immune globulin (IVIG), and/or rituximab. 12 TPE can be performed every other day until the goal, such as DSA threshold level for transplant, is met. 5…”

Section: Cardiac Transplantationmentioning

confidence: 99%

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The apheresis management of patients undergoing transplantation: a concise review

et al. 2019

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Cardiac Transplantationmentioning

confidence: 99%

Section: Cardiac Transplantationmentioning

confidence: 99%

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The apheresis management of patients undergoing transplantation: a concise review

et al. 2019

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“…On day 30, the patient has repeat IVIG 1 g/kg daily (with medication pre-treatment) for 2 additional days to a total maximal dosage of 140 g ( Figure 4 ). 40) …”

Section: Special Considerationmentioning

confidence: 99%

Heart Transplant Immunosuppression Strategies at Cedars-Sinai Medical Center

et al. 2021

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Heart transplant is the optimal treatment for selected patients with end-stage heart failure. Immunosuppression after heart transplantation has significantly reduced the incidence of rejection and improved patient outcomes with the routine use of calcineurin inhibitors. Antimetabolites and proliferation signal inhibitors add to the improvement in patient outcomes as well. The goal of induction therapy is to provide intense immunosuppression when the risk of allograft rejection is highest. Most maintenance immunosuppressive protocols employ a 3-drug regimen consisting of a calcineurin inhibitor, an antimetabolite agent and glucocorticoids. The management of rejection proceeds in a stepwise fashion based on the severity of rejection detected on biopsy and the patient's clinical presentation. This review will cover induction, maintenance, rejection therapy and some special considerations including sensitization, renal sparing protocol, and corticosteroid weaning. It will end in consideration of potential future directions in immunosuppressive strategies to promote patient and graft survival.

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