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

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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

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ASJC Scopus subject areas

  • Transplantation

Cite this

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, 23(2), 128-131. https://doi.org/10.7182/pit2013454