Treatment of Vascular Rejection With Rituximab in Cardiac Transplantation

Garrett, H. Edward; Duvall-Seaman, Denise; Helsley, B; Groshart, Kenneth

doi:10.1016/j.healun.2004.09.003

Cited by 72 publications

(50 citation statements)

References 16 publications

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“…73 Other studies in adult heart recipients have reported the effects of rituximab in treating refractory AMR. 75 Moreover, all conventional immunosuppressive therapies and desensitization regimens, including rituximab, have no effect on depletion of plasma cells. 14,49 Probably, the immunosuppressive treatments that fail to inhibit the mature plasma cells have little effect on reducing antibody production.…”

Section: Novel Approaches On Sensitized Patientsmentioning

confidence: 99%

Current Concepts in Histocompatibility During Heart Transplant

Picascia

Grimaldi²,

Zullo³

et al. 2012

Exp Clin Transplant

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Sensitized candidates for heart transplant usually end up on a long waiting list and have an increased risk of rejection, graft loss, and incidence of cardiac allograft vasculopathy. An increasing number of studies have demonstrated the negative effect of preformed and posttransplant antibodies on graft survival. Thus, in sensitized patients, the combination of new, appropriate, desensitization protocols, and monitoring of posttransplant development of donor-specific antibodies may improve short-term and long-term outcomes. Introduction of more-sensitive and more-specific techniques for antibody detection provides a valid tool for assessing the degree of pretransplant HLA histocompatibility, and, therefore, predicting the results of crossmatch in sensitized patients, which are difficult to transplant. Currently, there are no accurate and standard methods to determine the functional characteristics of antibodies detected by solid-phase assay and, therefore, to predict their clinical relevance. Therefore, the future of heart transplantation requires a better understanding of tissue typing techniques and the effect of anti-HLA antibodies on clinical outcome to prevent discrimination against sensitized patients at the time of organ allocation.

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Section: Novel Approaches On Sensitized Patientsmentioning

confidence: 99%

Current Concepts in Histocompatibility During Heart Transplant

Picascia

Grimaldi²,

Zullo³

et al. 2012

Exp Clin Transplant

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“…The elimination is usually completed by administration of intravenous immunoglobulin, which inhibits residual antibodies. An effective way of preventing further antibodies formation is suppression of B-lymphocytes (rituximab) (13) or plasma cells (bortezomib) (14). Table 4 presents the scenarios in which these treatment options were used.…”

Section: Original Articlementioning

confidence: 99%

Experience with cellular and antibody mediated rejection after heart transplantation

Málek¹,

GazdicÂ²,

Hegarová³

et al. 2015

Curr Res Cardiol

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ObjECTIvEs: To evaluate celluar and antibody mediated rejection in a group of patients after heart transplantation (HTX), performed in the authors' institution during a six-year period. METHOd: A retrospective analysis of patients surviving ≥12 months after HTX was performed. Rejection was evaluated from the samples obtained during endomyocardial biopsy, and graft function was assessed using echocardiography. The duration of follow-up ranged from 12 to 72 months. REsulTs:In the 196 patients evaluated, 65 treated episodes of cellular rejection were recorded in 50 patients, with significant reduction on tacrolimus prophylaxis. Antibody mediated rejection occured in 5.6% of patients, and was complicated by graft dysfunction in 64%. COnClusIOn: Contemporary immunosuppressive prophylaxis decreases the frequency of cellular rejection, allowing modification of endomyocardial biopsy schedule. Antibody mediated rejection is a relatively rare but clinically important complication after HTX, and necessitates combined agressive therapy.

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“…The data regarding infectious risk in transplant recipients is qualitatively poor. In a case series of 8 cardiac transplant recipients, 3 patients developed infections (Garrett et al, 2005).…”

Section: Considerations With Rituximab Usementioning

confidence: 99%