Detection and management of HLA sensitization in candidates for adult heart transplantation.
| Autor: | DeFilippis EM; Center for Advanced Cardiac Care, Division of Cardiology, Columbia University Irving Medical Center, New York, New York., Kransdorf EP; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California., Jaiswal A; Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, Hartford, Connecticut., Zhang X; HLA and Immunogenetics Laboratory, Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, California., Patel J; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California., Kobashigawa JA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California., Baran DA; Cleveland Clinic, Heart Vascular and Thoracic Institute, Weston, Florida., Kittleson MM; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California. Electronic address: Michelle.kittleson@cshs.org. |
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| Jazyk: | angličtina |
| Zdroj: | The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation [J Heart Lung Transplant] 2023 Apr; Vol. 42 (4), pp. 409-422. Date of Electronic Publication: 2022 Dec 27. |
| DOI: | 10.1016/j.healun.2022.12.019 |
| Abstrakt: | Heart transplantation (HT) remains the preferred therapy for patients with advanced heart failure. However, for sensitized HT candidates who have antibodies to human leukocyte antigens , finding a suitable donor can be challenging and can lead to adverse waitlist outcomes. In recent years, the number of sensitized patients awaiting HT has increased likely due to the use of durable and mechanical circulatory support as well as increasing number of candidates with underlying congenital heart disease. This State-of-the-Art review discusses the assessment of human leukocyte antigens antibodies, potential desensitization strategies including mechanisms of action and specific protocols, the approach to a potential donor including the use of complement-dependent cytotoxicity, flow cytometry, and virtual crossmatches, and peritransplant induction management. (Copyright © 2022 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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