HLA Sensitization in Pediatric Pre-transplant Cardiac Patients Supported by Mechanical Assist Devices: the Utility of Luminex

Yang, Jeremy; Schall, Cynthia; Smith, Doug; Kreuser, Lisa; Zamberlan, M.; King, Karen; Gajarski, Robert J.

doi:10.1016/j.healun.2008.11.908

Cited by 47 publications

(40 citation statements)

References 28 publications

(30 reference statements)

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Section: Risks Of Anti-hla Antibodies In the Pediatric Recipientmentioning

confidence: 97%

“…[271][272][273][274][275] In contrast, circulatory assist support with ECMO does not appear to result in elevated PRA levels. 265,274 There are conflicting reports regarding the incidence of an elevated PRA in children undergoing retransplantation. In an analysis from the multicenter Pediatric Heart Transplant Study, Chin et al 275a reported no significant differences in the mean PRA level between patients undergoing primary and retransplantation (1.5±4.9% versus 8.5±27.1%, respectively, P=NS); however, the proportion of patients with an elevated PRA >10% was not presented for either group.…”

Section: Risks Of Anti-hla Antibodies In the Pediatric Recipientmentioning

confidence: 97%

See 1 more Smart Citation

Antibody-Mediated Rejection in Cardiac Transplantation: Emerging Knowledge in Diagnosis and Management

Colvin¹,

Cook²,

Chang³

et al. 2015

Circulation

283

251

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Section: Risks Of Anti-hla Antibodies In the Pediatric Recipientmentioning

confidence: 97%

Section: Risks Of Anti-hla Antibodies In the Pediatric Recipientmentioning

confidence: 97%

Antibody-Mediated Rejection in Cardiac Transplantation: Emerging Knowledge in Diagnosis and Management

Colvin¹,

Cook²,

Chang³

et al. 2015

Circulation

283

251

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“…The increased formation of HLA antibodies and the susceptibility to systemic infections are sustained by an immune dysfunction secondary to VAD implantation (21). Hence, it has been an institutional routine to perform desensitization on pediatric patients being bridged to heart transplantation with a VAD.…”

Section: Allosensitizationmentioning

confidence: 99%

Role of paediatric assist device in bridge to transplant

Hetzer¹,

Mfdm²,

2018

Ann. Cardiothorac. Surg.

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“…available for ECMO, an important factor conferring risk in mechanically supported patients awaiting heart transplantation. 32,33 …”

Section: Almond Et Al Ecmo For Bridge To Heart Transplantation In Chimentioning

confidence: 99%

Extracorporeal Membrane Oxygenation for Bridge to Heart Transplantation Among Children in the United States

et al. 2011

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Background-Extracorporeal membrane oxygenation (ECMO) has served for Ͼ2 decades as the standard of care for US children requiring mechanical support as a bridge to heart transplantation. Objective data on the safety and efficacy of ECMO for this indication are limited. We describe the outcomes of ECMO as a bridge to heart transplantation to serve as performance benchmarks for emerging miniaturized assist devices intended to replace ECMO. Methods and Results-Data from the Extracorporeal Life Support Organization Registry and the Organ ProcurementTransplant Network database were merged to identify children supported with ECMO and listed for heart transplantation from 1994 to 2009. Independent predictors of wait-list and posttransplantation in-hospital mortality were identified. Objective performance goals for ECMO were developed. Of 773 children, the median age was 6 months (interquartile range, 1 to 44 months); 28% had cardiomyopathy; and in 38%, a bridge to transplantation was intended at ECMO initiation. Overall, 45% of subjects reached transplantation, although one third of those transplanted died before discharge; overall survival to hospital discharge was 47%. Wait-list mortality was independently associated with congenital heart disease, cardiopulmonary resuscitation before ECMO, and renal dysfunction. Posttransplantation mortality was associated with congenital heart disease, renal dysfunction, ECMO duration of Ͼ14 days, and initial ECMO indication as a bridge to recovery. In the objective performance goal cohort (nϭ485), patients with cardiomyopathy had the highest survival to hospital discharge (63%), followed by patients with myocarditis (59%), 2-ventricle congenital heart disease (44%) and 1-ventricle congenital heart disease (33%). Conclusion-Although ECMO is effective for short-term circulatory support, it is not reliable for the long-term circulatory support necessary for children awaiting heart transplantation. Fewer than half of patients bridged with ECMO survive to hospital discharge. More effective modalities for chronic circulatory support in children are urgently needed. (Circulation. 2011;123:2975-2984.)

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HLA Sensitization in Pediatric Pre-transplant Cardiac Patients Supported by Mechanical Assist Devices: the Utility of Luminex

Cited by 47 publications

References 28 publications

Antibody-Mediated Rejection in Cardiac Transplantation: Emerging Knowledge in Diagnosis and Management

Antibody-Mediated Rejection in Cardiac Transplantation: Emerging Knowledge in Diagnosis and Management

Role of paediatric assist device in bridge to transplant

Extracorporeal Membrane Oxygenation for Bridge to Heart Transplantation Among Children in the United States

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