The use of circulating donor specific antibody to predict biopsy diagnosis of antibody-mediated rejection and to provide prognostic value after heart transplantation in children

Ware, Adam L.; Malmberg, Elisabeth; Delgado, Julio; Hammond, M. Elizabeth H.; Miller, Dylan V.; Stehlik, Josef; Kfoury, Abdallah G.; Revelo, Mônica P.; Eckhauser, Aaron; Everitt, Melanie D.

doi:10.1016/j.healun.2015.10.006

Cited by 34 publications

(32 citation statements)

References 31 publications

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“…Consistent with previous reports, 4,33,34 heart transplant recipients with post-transplant DSA had a higher incidence of AMR compared to recipients without DSA. Of particular interest is our observation that recipients who developed IgG+/C1q+ DSA had a significantly higher incidence of AMR than recipients with IgG+/C1q− DSA.…”

Section: Post-transplant Dsa and Antibody-mediated Rejectionsupporting

confidence: 91%

The role of complement‐fixing donor‐specific antibodies identified by a C1q assay after heart transplantation

Farrero¹,

Pando

Luo

et al. 2017

Clinical Transplantation

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Section: Post-transplant Dsa and Antibody-mediated Rejectionsupporting

confidence: 91%

The role of complement‐fixing donor‐specific antibodies identified by a C1q assay after heart transplantation

Farrero¹,

Pando

Luo

et al. 2017

Clinical Transplantation

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“…Similarly, using the C1q assay, which detects only complement-fixing antibodies, the presence of C1q fixing DSA prior to or early after HT had a positive predictive value of 100%, while absence of C1q fixing DSA had a negative predictive value of 100% for AMR ( 42 ). In another analysis, the presence of circulating DSA had 93% sensitivity, 62% specificity, 24% positive predictive value, and 99% negative predictive value for biopsy diagnosis of AMR in pediatric recipients ( 43 ). In addition, higher levels of circulating DSA measured by MFI correlated with pAMR severity ( 43 ).…”

Section: Pediatric Htmentioning

confidence: 99%

Significance of Anti-HLA Antibodies on Adult and Pediatric Heart Allograft Outcomes

et al. 2017

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As methods for human leukocyte antigens (HLA) antibody detection have evolved and newer solid phase assays are much more sensitive, the last 15 years has seen a renewed focus on the importance of HLA antibodies in solid organ transplant rejection. However, there is still much controversy regarding the clinical significance of antibody level as depicted by the mean fluorescence intensity of a patient’s neat serum. Emerging techniques, including those that identify antibody level and function, show promise for the detection of individuals at risk of allograft rejection, determination of the effectiveness of desensitization prior to transplant, and for monitoring treatment of rejection. Here, we review current publications regarding the relevance of donor-specific HLA antibodies (DSA) in adult and pediatric heart transplantation (HT) with graft survival, development of antibody-mediated rejection and cardiac allograft vasculopathy (CAV). The negative impact of DSA on patient and allograft survival is evident in adult and pediatric HT recipients. Many questions remain regarding the most appropriate frequency of assessment of pre- and posttransplant DSA as well as the phenotype of DSA memory vs. true de novo antibody using large multicenter adult and pediatric cohorts and state-of-the-art methodologies for DSA detection and characterization.

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“…Furthermore, DSA are associated with progression to cardiac allograft vasculopathy and reduced long‐term cardiac allograft survival . DSA testing shows outstanding sensitivity and negative predictive value for biopsy‐diagnosed AMR in both adult and pediatric cardiac transplant recipients . In posttransplant care, quantitative DSA should be an essential component in the surveillance for AMR.…”

Section: The Place Of Antibody Detection In Amr Assessment In Heart Tmentioning

confidence: 99%

The XIIIth Banff Conference on Allograft Pathology: The Banff 2015 Heart Meeting Report: Improving Antibody-Mediated Rejection Diagnostics: Strengths, Unmet Needs, and Future Directions

Bruneval

Angelini

Miller

et al. 2017

American Journal of Transplantation

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The 13th Banff Conference on Allograft Pathology was held in Vancouver, British Columbia, Canada from October 5 to 10, 2015. The cardiac session was devoted to current diagnostic issues in heart transplantation with a focus on antibody‐mediated rejection (AMR) and small vessel arteriopathy. Specific topics included the strengths and limitations of the current rejection grading system, the central role of microvascular injury in AMR and approaches to semiquantitative assessment of histopathologic and immunophenotypic indicators, the role of AMR in the development of cardiac allograft vasculopathy, the important role of serologic antibody detection in the management of transplant recipients, and the potential application of new molecular approaches to the elucidation of the pathophysiology of AMR and potential for improving the current diagnostic system. Herein we summarize the key points from the presentations, the comprehensive, open and wide‐ranging multidisciplinary discussion that was generated, and considerations for future endeavors.

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The use of circulating donor specific antibody to predict biopsy diagnosis of antibody-mediated rejection and to provide prognostic value after heart transplantation in children

Cited by 34 publications

References 31 publications

The role of complement‐fixing donor‐specific antibodies identified by a C1q assay after heart transplantation

The role of complement‐fixing donor‐specific antibodies identified by a C1q assay after heart transplantation

Significance of Anti-HLA Antibodies on Adult and Pediatric Heart Allograft Outcomes

The XIIIth Banff Conference on Allograft Pathology: The Banff 2015 Heart Meeting Report: Improving Antibody-Mediated Rejection Diagnostics: Strengths, Unmet Needs, and Future Directions

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