Cardiac antibody–mediated rejection


Clifford Chin, MD, The Heart Institute, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue – MLC 2003, Cincinnati, OH 45229-3039, USA
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Chin C. Cardiac antibody–mediated rejection.

Abstract:  Many factors limit short- and long-term survival after pediatric heart transplantation. Historically, attention had been directed toward T-cell responses and acute cellular rejection. Presence of pretransplant antibodies against HLA is associated with increased donor wait times and poor post-transplant outcomes. Therapies aimed to mitigate circulating antibodies include plasmapheresis, protein A immunoadsorption columns, intravenous immune globulin, rituximab, and bortezomib. The negative effects of B cells, HLA antibodies, and AMR and potential interventions are the focus of this review article.