Heart transplant with donor-specific antibody after immunoadsorption plus rituximab: A case report

Marianna Resse, Ciro Maiello, Francesco Cacciatore, Gianpaolo Romano, Chiara Sabia, Antonietta Picascia, Fabio Ursomando, Claudio Napoli

Research output: Contribution to journalArticle

Abstract

Different desensitization strategies are available for treating patients with preformed human leukocyte antigen (HLA) antibodies. A highly presensitized heart recipient received immunoadsorption and rituximab therapy. The patient, with end-stage heart failure, was positive only for antibodies of HLA class I (anti-A2, A10, B17), and Luminex platform (One Lambda kit) showed a panel-reactive antibody score of 64%. The patient's serum was tested repeatedly in both complement-dependent cytotoxicity and flow-cytometry crossmatches against cells from different potential organ donors. The results of these crossmatches were positive on flow cytometry when tested with HLA-A2, A10, and B17 but were still negative on cytotoxicity. The patient was treated with a desensitization regimen; this treatment immediately decreased antibody levels of 70% and the patient subsequently received a transplant with donor-specific HLA antibody (HLA-A2). After more than 2 years, graft function remains normal and the clinical status of the patient is stable.

Original languageEnglish
Pages (from-to)128-131
Number of pages4
JournalProgress in Transplantation
Volume23
Issue number2
DOIs
Publication statusPublished - Jun 1 2013

Fingerprint

HLA Antigens
Tissue Donors
Transplants
Antibodies
varespladib methyl
antineoplaston A10
Flow Cytometry
Rituximab
Heart Failure
Therapeutics
Serum

ASJC Scopus subject areas

  • Transplantation

Cite this

Heart transplant with donor-specific antibody after immunoadsorption plus rituximab : A case report. / Resse, Marianna; Maiello, Ciro; Cacciatore, Francesco; Romano, Gianpaolo; Sabia, Chiara; Picascia, Antonietta; Ursomando, Fabio; Napoli, Claudio.

In: Progress in Transplantation, Vol. 23, No. 2, 01.06.2013, p. 128-131.

Research output: Contribution to journalArticle

Resse, M, Maiello, C, Cacciatore, F, Romano, G, Sabia, C, Picascia, A, Ursomando, F & Napoli, C 2013, 'Heart transplant with donor-specific antibody after immunoadsorption plus rituximab: A case report', Progress in Transplantation, vol. 23, no. 2, pp. 128-131. https://doi.org/10.7182/pit2013454
Resse, Marianna ; Maiello, Ciro ; Cacciatore, Francesco ; Romano, Gianpaolo ; Sabia, Chiara ; Picascia, Antonietta ; Ursomando, Fabio ; Napoli, Claudio. / Heart transplant with donor-specific antibody after immunoadsorption plus rituximab : A case report. In: Progress in Transplantation. 2013 ; Vol. 23, No. 2. pp. 128-131.
@article{8d2382d5a5b347618b6960fde61679c4,
title = "Heart transplant with donor-specific antibody after immunoadsorption plus rituximab: A case report",
abstract = "Different desensitization strategies are available for treating patients with preformed human leukocyte antigen (HLA) antibodies. A highly presensitized heart recipient received immunoadsorption and rituximab therapy. The patient, with end-stage heart failure, was positive only for antibodies of HLA class I (anti-A2, A10, B17), and Luminex platform (One Lambda kit) showed a panel-reactive antibody score of 64{\%}. The patient's serum was tested repeatedly in both complement-dependent cytotoxicity and flow-cytometry crossmatches against cells from different potential organ donors. The results of these crossmatches were positive on flow cytometry when tested with HLA-A2, A10, and B17 but were still negative on cytotoxicity. The patient was treated with a desensitization regimen; this treatment immediately decreased antibody levels of 70{\%} and the patient subsequently received a transplant with donor-specific HLA antibody (HLA-A2). After more than 2 years, graft function remains normal and the clinical status of the patient is stable.",
author = "Marianna Resse and Ciro Maiello and Francesco Cacciatore and Gianpaolo Romano and Chiara Sabia and Antonietta Picascia and Fabio Ursomando and Claudio Napoli",
year = "2013",
month = "6",
day = "1",
doi = "10.7182/pit2013454",
language = "English",
volume = "23",
pages = "128--131",
journal = "Progress in Transplantation",
issn = "1526-9248",
publisher = "InnoVision Communications",
number = "2",

}

TY - JOUR

T1 - Heart transplant with donor-specific antibody after immunoadsorption plus rituximab

T2 - A case report

AU - Resse, Marianna

AU - Maiello, Ciro

AU - Cacciatore, Francesco

AU - Romano, Gianpaolo

AU - Sabia, Chiara

AU - Picascia, Antonietta

AU - Ursomando, Fabio

AU - Napoli, Claudio

PY - 2013/6/1

Y1 - 2013/6/1

N2 - Different desensitization strategies are available for treating patients with preformed human leukocyte antigen (HLA) antibodies. A highly presensitized heart recipient received immunoadsorption and rituximab therapy. The patient, with end-stage heart failure, was positive only for antibodies of HLA class I (anti-A2, A10, B17), and Luminex platform (One Lambda kit) showed a panel-reactive antibody score of 64%. The patient's serum was tested repeatedly in both complement-dependent cytotoxicity and flow-cytometry crossmatches against cells from different potential organ donors. The results of these crossmatches were positive on flow cytometry when tested with HLA-A2, A10, and B17 but were still negative on cytotoxicity. The patient was treated with a desensitization regimen; this treatment immediately decreased antibody levels of 70% and the patient subsequently received a transplant with donor-specific HLA antibody (HLA-A2). After more than 2 years, graft function remains normal and the clinical status of the patient is stable.

AB - Different desensitization strategies are available for treating patients with preformed human leukocyte antigen (HLA) antibodies. A highly presensitized heart recipient received immunoadsorption and rituximab therapy. The patient, with end-stage heart failure, was positive only for antibodies of HLA class I (anti-A2, A10, B17), and Luminex platform (One Lambda kit) showed a panel-reactive antibody score of 64%. The patient's serum was tested repeatedly in both complement-dependent cytotoxicity and flow-cytometry crossmatches against cells from different potential organ donors. The results of these crossmatches were positive on flow cytometry when tested with HLA-A2, A10, and B17 but were still negative on cytotoxicity. The patient was treated with a desensitization regimen; this treatment immediately decreased antibody levels of 70% and the patient subsequently received a transplant with donor-specific HLA antibody (HLA-A2). After more than 2 years, graft function remains normal and the clinical status of the patient is stable.

UR - http://www.scopus.com/inward/record.url?scp=84879393505&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84879393505&partnerID=8YFLogxK

U2 - 10.7182/pit2013454

DO - 10.7182/pit2013454

M3 - Article

C2 - 23782659

AN - SCOPUS:84879393505

VL - 23

SP - 128

EP - 131

JO - Progress in Transplantation

JF - Progress in Transplantation

SN - 1526-9248

IS - 2

ER -