Safety and Efficacy of Immunoadsorption in Heart Transplantation Program

Abstract

(patients > 18 and < 18 years of age, respectively). Time to > 50% reduction in GFR was then compared in a uni-and multivariate Cox regression model between the patients with and without proteinuria. In the multivariate model, adjustments were made for previously identified risk factors for CKD after HT, including age, sex, hypertension and diabetes mellitus. P < 0.05 was considered statistically significant. Results: Data from urine test strips was available in 79 patients, out of which 13 were positive for proteinuria. 1 year after HT, median GFR was 53 (range 20-81) vs. 56 (range 28-111) mL/min/1.73m2 in patients with and without proteinuria, respectively, at this time point (p= 0.28). In the Cox-regression analysis, proteinuria the first year after HT was related to a higher rate of GFR-decline, with a hazard ratio (95% confidence interval, p-value) of 2.46 (1.04-5.82, p= 0.04) and 5.15 (1.23-21.55, p= 0.03) in the uni-and multivariate model, respectively. Conclusion: Our results indicate that proteinuria the first year after HT is a predictor of GFR-decline. Special attention should therefore be given to patients with proteinuria early after HT. Larger multicenter studies including more patients are encouraged to verify the results of the present study.

Safety and Efficacy of Immunoadsorption as an Add-On to Medical Treatment in Patients with Severe Idiopathic Pulmonary Arterial Hypertension

“…Using IA, antibodies were nonspecifically removed by an adsorber [14] without any need to substitute blood products. IA has previously been used for various indications such as dilated cardiomyopathy (DCM) [15,16] , connective tissue diseases [17,18] , and myocarditis [19] , as well as during heart transplantation [20] . First experiences with IA using the medical device TheraSorb TM -Ig Flex Adsorber with a LIFE 18 ® Apheresis System in 4 PAH patients were encouraging and revealed good tolerability of the treatment and improvements in noninvasively measured right ventricular size, pulmonary artery pressures, peak oxygen uptake, and 6-min walk distance [12] .…”