New-onset graft dysfunction after heart transplantation—incidence and mechanism-related outcomes

Shahzad, Khurram; Aziz, Quratul Ain; Leva, J.; Cadeiras, Martín; Ho, Eric K.; Vlad, George; Vasilescu, Elena R.; Latif, F.; Sinha, Ayan; Burke, Elizabeth

doi:10.1016/j.healun.2010.08.026

Cited by 35 publications

(40 citation statements)

References 27 publications

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“…AMR manifests in approximately 10% to 20% of heart transplant patients and has been associated with poor outcomes, including development of cardiac allograft vasculopathy (CAV), graft dysfunction, and mortality [3,4]. Consensus agreement on the definition, nomenclature, and diagnosis of AMR, or humoral rejection is still evolving.…”

Section: Introductionmentioning

confidence: 99%

Correlations of lymphocyte subset infiltrates with donor-specific antibodies and acute antibody-mediated rejection in endomyocardial biopsies

Frank

Dean

Molina

et al. 2015

Cardiovascular Pathology

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Section: Introductionmentioning

confidence: 99%

Correlations of lymphocyte subset infiltrates with donor-specific antibodies and acute antibody-mediated rejection in endomyocardial biopsies

Frank

Dean

Molina

et al. 2015

Cardiovascular Pathology

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“…[6][7][8] Heart transplant in immunized patients continues to be a risk factor owing to immuno suppression-related complications, such as infection, rejection, and graft coronary vasculopathy. 9,10 In the last few years, loads of evidence have indicated that preallosensitization and postallosensitization have a negative clinical effect on the outcome and long-term survival of the heart graft. 11 For this reason, great emphasis has been placed on systems to detect allosensitization and donor-specific anti-HLA antibodies (DSA) before and after heart transplant.…”

Section: Introductionmentioning

confidence: 99%

Current Concepts in Histocompatibility During Heart Transplant

Picascia

Grimaldi²,

Zullo³

et al. 2012

Exp Clin Transplant

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Sensitized candidates for heart transplant usually end up on a long waiting list and have an increased risk of rejection, graft loss, and incidence of cardiac allograft vasculopathy. An increasing number of studies have demonstrated the negative effect of preformed and posttransplant antibodies on graft survival. Thus, in sensitized patients, the combination of new, appropriate, desensitization protocols, and monitoring of posttransplant development of donor-specific antibodies may improve short-term and long-term outcomes. Introduction of more-sensitive and more-specific techniques for antibody detection provides a valid tool for assessing the degree of pretransplant HLA histocompatibility, and, therefore, predicting the results of crossmatch in sensitized patients, which are difficult to transplant. Currently, there are no accurate and standard methods to determine the functional characteristics of antibodies detected by solid-phase assay and, therefore, to predict their clinical relevance. Therefore, the future of heart transplantation requires a better understanding of tissue typing techniques and the effect of anti-HLA antibodies on clinical outcome to prevent discrimination against sensitized patients at the time of organ allocation.

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“…The reported incidence of de novo AMR varies widely based upon the definitions used and at which point on the spectrum a study defines AMR. Epidemiologic studies in centers that perform protocolized endomyocardial biopsies have shown a wide variability in incidence of 3 -51% (Michaels et al, 2003;Shahzad et al, 2011). Not surprisingly, those institutions that include circulating antibodies without evidence of graft dysfunction had a higher reported incidence of AMR.…”

Section: Epidemiologymentioning

confidence: 99%