Treatment of Asymptomatic Donor Specific Antibody After Heart Transplantation: Is It Beneficial?

Rushworth, Parker; Singer-Englar, T.; Patel, N.; Patel, Jignesh; Kittleson, M.; Chang, David C.; Kransdorf, Evan; Kobashigawa, J.A.

doi:10.1016/s0735-1097(21)01930-6

Cited by 1 publication

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previously our center showed no additional predictive value for mortality for complementfixing versus non-complement-fixing DSA, 2 but a recent larger study showed worse 3-year survival and freedom from MACE in patients with asymptomatic complement-fixing DSA despite treatment with IVIG and rituximab. 29 In summary, in this study the development of de novo anti-HLA DSA post-transplantation was observed in 24% of patients and (on competing risk model analysis) was associated with a 1.8-fold increase in mortality and a 2.5-fold increase in MACE, with most of the separation in time to first MACE occurring early after the detection of DSA.…”

Section: Discussionmentioning

confidence: 57%

“…Such testing can be helpful to assess the clinical significance of detected DSA but was not the focus of this study. Previously our center showed no additional predictive value for mortality for complement‐fixing versus non‐complement‐fixing DSA, 2 but a recent larger study showed worse 3‐year survival and freedom from MACE in patients with asymptomatic complement‐fixing DSA despite treatment with IVIG and rituximab 29 …”

Section: Discussionmentioning

confidence: 85%

See 1 more Smart Citation

Donor specific antibodies association with survival and adverse events after heart transplantation: A single center retrospective study between 2006 and 2021

Akhtar

Peterzan

Banya

et al. 2023

Clinical Transplantation

View full text Add to dashboard Cite

Objective Newly detected donor HLA‐specific antibodies (DSA) are historically known to be associated with reduced survival in heart transplant patients. Our objective is to clarify the modern incidence of DSA and determine its relationship with survival and MACE. Methods This retrospective study included all patients undergoing orthotopic heart transplantation at Harefield Hospital, London between January 1, 2006 and May 31, 2021. We identified patients who developed DSA at any point post heart transplantation and its effect on survival and MACE (defined as rejection, coronary event, stroke, and arrhythmia. Results In total of 232 patients were included with a median follow up time of 4.7 years post heart transplantation. 23.7% of patients included developed DSA post heart transplantation. There was a significantly increased risk of death in patients developing DSA versus not (sub distribution hazard ratio [SHR] 1.83, 95% confidence interval 1.03–3.24, p = .04). At the time of detection of DSA, 38.2% of the cohort had rejection necessitating treatment. A MACE event had occurred in 48.1% by 2 years and 53.7% by 3 years in the DSA cohort. There was a significantly increased risk of MACE in patients developing DSA versus not (SHR 2.48 [1.58–3.89, p < .0001]). Conclusions This study showed an increased risk of death and MACE in patients developing DSA post heart transplantation. Further research is required into the optimal management of these patients

show abstract

Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 85%