Outcomes in highly sensitized pediatric heart transplant patients using current management strategies

Allosensitization does not alter post‐transplant outcomes in pediatric patients bridged to transplant with a ventricular assist device

“…The database does not include HLA information on patients not transplanted; therefore, frequency of HLA sensitization does not include these patients. Details about the peritransplant management strategies or immunomodulatory therapy that might have been used to decrease the impact of sensitization on post‐transplant outcomes are also not captured .…”

Indications for and outcomes of therapeutic plasma exchange after cardiac transplantation: A single center retrospective study

“…20,21 The ability to accept a high-risk transplant with TPE support, rather than the certainty of death, increases the likelihood that a patient who is highly sensitized will be able to undergo a heart transplant. 22,23 In light of the above, it is most likely that our TPEtreated patients did worse, not because they received TPE but rather, as a result of the underlying indication for which they received TPE. The role of TPE as a tool to minimize survival differences between the cohorts should be examined in future studies.…”

“…In spite of the decreased survival outcomes of the Multiple and Delayed TPE cohorts, we consider these survival rates to be acceptable when compared to the survival rates of decompensated heart failure without transplant . The ability to accept a high‐risk transplant with TPE support, rather than the certainty of death, increases the likelihood that a patient who is highly sensitized will be able to undergo a heart transplant …”

The Experience of Pediatric Heart Transplantation on North-West of Russian Federation

“…Реактивность иммунного ответа у реципиентов до 18 лет закономерно выше, чем у более возрастной категории больных, что, в свою очередь, увеличивает частоту отторжения [19]. В этой связи отторжение трансплантата у детей представляет собой одну из причин смертности в раннем послеоперационном пе-риоде, а также посттрансплантационных осложнений [20].…”

“…По результатам КРТ, через год после ТС выявлено увеличение толерантности к ФН по сравнению с дан-ными до операции, в связи с увеличением физичес-кой активности отмечена положительная динамика VO 2peak (18,4 мл/мин/кг (15,(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)9), 60,5% (40-89%) от должной величины) и Ve/VCO 2 (34,0 (30,5-40,7). Учитывая более длительный срок наблюдения у пациенток № 1, 2, 3, в динамике к трем годам вы-явлено дальнейшее улучшение показателей по ре-зультатам КРТ: VO 2peak -19,4 мл/мин/кг (14,2-24,3), 69% (46-94) от должной величины; Ve/VCO 2 -33,2 (23,7-41,30) (рис.…”