Outcome of Cardiac Transplant Recipients With a Positive Donor-Specific Crossmatch—preliminary Results With Plasmapheresis

Ratkovec, Ranae M.; Hammond, Elizabeth H.; O’Connell, John B.; Bristow, Michael R.; Dewitt, Charles W.; Richenbacher, Wayne E.; Millar, Roger C.; Renlund, Dale G.

doi:10.1097/00007890-199210000-00017

Cited by 98 publications

(48 citation statements)

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“…In other published plasmapheresis series (8,18), the number of sessions has varied from 3 to 19; our patients underwent a minimum of 7 daily sessions, and if the rejection episode had not resolved by then, daily sessions were continued until it did resolve. The maximum number of sessions applied was 19.…”

Section: Discussionmentioning

confidence: 99%

Humoral Heart Rejection (Severe Allograft Dysfunction with no Signs of Cellular Rejection or Ischemia): Incidence, Management, and the Value of C4d for Diagnosis

Crespo‐Leiro¹,

Veiga‐Barreiro²,

Doménech

et al. 2005

American Journal of Transplantation

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Severe allograft dysfunction after heart transplant (HT), without ischemia or evidence of cellular rejection upon endomyocardial biopsy (EMB), is a rare but potentially fatal condition that suggests humoral rejection (HR). Its incidence, and the methods of choice for its diagnosis and management, remain uncertain. We retrospectively studied 445 HT patients (April 1991-December 2003) to determine incidence of HR diagnosed by clinical and conventional histopathological criteria. We used immunofluorescence (IF) techniques to test archived frozen EMB issue for IgM, IgG, C1q, C3, fibrin and C4d. Twelve patients (2.7%) fulfilled the criteria for HR after a mean time post-HT of 21.3 ± 24.7 months (range: 2-72 months). Patients were treated with high doses of steroids and plasmapheresis, with successful recovery in 11 cases. IF studies using classical markers were mainly negative for the six patients with enough EMB tissue for testing. All six patients showed positivity for C4d during the HR episode but not before or after. Humoral rejection was observed in less than 3% of HT patients. Plasmapheresis treatment was highly effective. Classical IF tests were not useful for diagnosis, but C4d appears to be useful both for confirmation of diagnosis and for monitoring response to treatment.

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Section: Discussionmentioning

confidence: 99%

Humoral Heart Rejection (Severe Allograft Dysfunction with no Signs of Cellular Rejection or Ischemia): Incidence, Management, and the Value of C4d for Diagnosis

Crespo‐Leiro¹,

Veiga‐Barreiro²,

Doménech

et al. 2005

American Journal of Transplantation

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“…126,127 Plasma exchange has also been reported to facilitate transplantation across a positive crossmatch by decreasing the likelihood of subsequent allograft rejection. 127,128 There is little support for the use of plasma exchange as monotherapy for the management of AMR. Treatment with plasma exchange for the reduction of alloantibody levels has always been reported in combination with other immunomodulatory therapies.…”

Section: Intravenous Gamma Globulinmentioning

confidence: 99%

Antibody-Mediated Rejection in Cardiac Transplantation: Emerging Knowledge in Diagnosis and Management

Colvin¹,

Cook²,

Chang³

et al. 2015

Circulation

287

251

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“…Although preformed anti-donor antibodies can cause early heart transplant rejection and compromise patient survival (Singh et al, 1983;Ratkovec et al, 1992), pretransplant crossmatch is performed only occasionally in heart transplantation. The liver is less susceptible to antibody induced damage (Fung et al, 1987), although recent reports indicate that preformed antibodies do represent a higher risk for rejection (Takaya et al, 1992;Nikaein et al, 1994).…”

Section: Clinical Applicationmentioning

confidence: 99%

Applications of Flow Cytometry in Solid Organ Allogeneic Transplantation

Kirmizis¹,

Chatzidimitriou²,

Chatzopoulou³

et al. 2012

Clinical Flow Cytometry - Emerging Applications

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Outcome of Cardiac Transplant Recipients With a Positive Donor-Specific Crossmatch—preliminary Results With Plasmapheresis

Cited by 98 publications

References 0 publications

Humoral Heart Rejection (Severe Allograft Dysfunction with no Signs of Cellular Rejection or Ischemia): Incidence, Management, and the Value of C4d for Diagnosis

Humoral Heart Rejection (Severe Allograft Dysfunction with no Signs of Cellular Rejection or Ischemia): Incidence, Management, and the Value of C4d for Diagnosis

Antibody-Mediated Rejection in Cardiac Transplantation: Emerging Knowledge in Diagnosis and Management

Applications of Flow Cytometry in Solid Organ Allogeneic Transplantation

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