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The management of antibodies in heart transplantation: An ISHLT consensus document.

Authors :
Kobashigawa, Jon
Colvin, Monica
Potena, Luciano
Dragun, Duska
Crespo-Leiro, Maria G.
Delgado, Juan F.
Olymbios, Michael
Parameshwar, Jayan
Patel, Jignesh
Reed, Elaine
Reinsmoen, Nancy
Rodriguez, E. Rene
Ross, Heather
Starling, Randall C.
Tyan, Dolly
Urschel, Simon
Zuckermann, Andreas
Source :
Journal of Heart & Lung Transplantation. May2018, Vol. 37 Issue 5, p537-547. 11p.
Publication Year :
2018

Abstract

Despite the successes from refined peri-operative management techniques and immunosuppressive therapies, antibodies remain a serious cause of morbidity and mortality for patients both before and after heart transplantation. Patients awaiting transplant who possess antibodies against human leukocyte antigen are disadvantaged by having to wait longer to receive an organ from a suitably matched donor. The number of pre-sensitized patients has been increasing, a trend that is likely due to the increased use of mechanical circulatory support devices. Even patients who are not pre-sensitized can go on to produce donor-specific antibodies after transplant, which are associated with worse outcomes. The difficulty in managing antibodies is uncertainty over which antibodies are of clinical relevance, which patients to treat, and which treatments are most effective and safe. There is a distinct lack of data from prospective trials. An international consensus conference was organized and attended by 103 participants from 75 centers to debate contentious issues, determine the best practices, and formulate ideas for future research on antibodies. Prominent experts presented state-of-the-art talks on antibodies, which were followed by group discussions, and then, finally, a reconvened session to establish consensus where possible. Herein we address the discussion, consensus points, and research ideas. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
10532498
Volume :
37
Issue :
5
Database :
Academic Search Index
Journal :
Journal of Heart & Lung Transplantation
Publication Type :
Academic Journal
Accession number :
129122148
Full Text :
https://doi.org/10.1016/j.healun.2018.01.1291