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 -