scholarly journals Management of the Sensitized Cardiac Transplantation Recipient

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Michael Mazzei ◽  
Suresh Keshavamurthy ◽  
Olga Timofeeva ◽  
Yoshiya Toyoda ◽  
◽  
...  
Keyword(s):  
Human Leukocyte ◽  
Wait Time ◽  
Cardiac Transplant ◽  
Hla Antibodies ◽  
Leukocyte Antigen ◽  
Transplant Patients ◽  
Cardiac Transplant Recipient ◽  
Transplant Candidates ◽  
Management Challenge ◽  
Transplantation Recipient

Preoperative sensitization of the cardiac transplant recipient, defined as the presence of anti-Human Leukocyte Antigen (HLA) antibodies before transplant, represents a significant management challenge for physicians. Sensitization prolongs the pre-transplant wait time and is associated with postoperative transplant complications and death. It is critical that sensitized heart transplant candidates be identified and optimized before surgery. In this review, we describe the risk for sensitization, discuss the means through which sensitization may be diagnosed, and highlight some of the new therapeutic options for managing the sensitized cardiac transplant patients.

Human Leukocyte Antigen Typing in Legionella-Positive Transplant Patients

Legionella ◽  
2014 ◽  
pp. 196-199
Author(s):  
Marcela Jaresova ◽  
Nina Bendukidze ◽  
Eva Ivaskova ◽  
Ilja Striz ◽  
Ivo Hlozanek ◽  
...  
Keyword(s):  
Human Leukocyte Antigen ◽  
Human Leukocyte ◽  
Human Leukocyte Antigen Typing ◽  
Leukocyte Antigen ◽  
Transplant Patients

Outcome of Liver Transplant Patients With Preformed Donor‐Specific Anti–Human Leukocyte Antigen Antibodies

2019 ◽  
Vol 26 (2) ◽  
pp. 256-267 ◽  
Author(s):  
Arnaud Del Bello ◽  
Martine Neau‐Cransac ◽  
Laurence Lavayssiere ◽  
Valérie Dubois ◽  
Nicolas Congy‐Jolivet ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Human Leukocyte Antigen ◽  
Human Leukocyte ◽  
Leukocyte Antigen ◽  
Transplant Patients

scholarly journals Leukocyte depletion of random single-donor platelet transfusions does not prevent secondary human leukocyte antigen-alloimmunization and refractoriness: a randomized prospective study

Blood ◽  
1995 ◽  
Vol 85 (3) ◽  
pp. 824-828 ◽  
Author(s):  
K Sintnicolaas ◽  
M van Marwijk Kooij ◽  
HC van Prooijen ◽  
BA van Dijk ◽  
WL van Putten ◽  
...  
Keyword(s):  
Human Leukocyte Antigen ◽  
Platelet Transfusion ◽  
Human Leukocyte ◽  
Hematologic Malignancies ◽  
Standard Group ◽  
Hla Antibodies ◽  
Leukocyte Antigen ◽  
Leukocyte Depletion ◽  
Single Donor ◽  
Platelet Transfusions

We studied the value of leukocyte depletion of platelet transfusions for the prevention of secondary human leukocyte antigen (HLA)- alloimmunization in patients with a high-risk of prior immunization induced by pregnancies. Seventy-five female patients with hematologic malignancies (mostly acute leukemia) and a history of pregnancy were randomized to receive either standard random single-donor platelet transfusions (mean leukocytes, 430 x 10(6) per transfusion) or leukocyte-depleted random single-donor platelet transfusions. Leukocyte depletion to less than 5 x 10(6) leukocytes per platelet transfusion (mean leukocytes, 2 x 10(6) per transfusion) was achieved by filtration. Of the 62 evaluable patients, refractoriness to random donor platelets occurred in 41% (14 of 34) of the patients in the standard group and in 29% (8 of 28) of the patients in the filtered group (P = .52); anti-HLA antibodies developed in 43% (9 of 21) of individuals in the standard group and 44% (11 of 25) of cases in the filtered group. The time toward refractoriness and development of anti- HLA antibodies was similar for both groups. We conclude that leukocyte depletion of random single-donor platelet products to less than 5 x 10(6) per transfusion does not reduce the incidence of refractoriness to random donor platelet transfusion because of boostering of anti-HLA antibodies.

scholarly journals Donor-specific and -nonspecific HLA antibodies and outcome post lung transplantation

2017 ◽  
Vol 50 (5) ◽  
pp. 1701248 ◽  
Author(s):  
Stijn E. Verleden ◽  
Bart M. Vanaudenaerde ◽  
Marie-Paul Emonds ◽  
Dirk E. Van Raemdonck ◽  
Arne P. Neyrinck ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Graft Survival ◽  
Human Leukocyte ◽  
Term Outcome ◽  
Hla Antibodies ◽  
Long Term Outcome ◽  
Leukocyte Antigen ◽  
Post Transplant ◽  
Antibody Mediated Rejection ◽  
Hla Dq

Donor-specific antibodies (DSAs) against human leukocyte antigen (HLA) are associated with chronic lung allograft dysfunction (CLAD) and mortality post lung transplantation, but data concerning prevalence, time of onset, persistence and effects on long-term outcome remain scarce.We assessed the association between HLA antibodies and CLAD-free and graft survival in a cohort of 362 patients. We stratified our analysis according to DSA status, persistence of antibodies and timing of antibodies (pre-transplant, early or late post-transplant).Within our cohort, 61 (17%) patients developed DSAs (mostly against HLA-DQ), which was associated with worse CLAD-free and graft survival (p<0.0001 and p=0.059, respectively). Persistent (hazard ratio (HR) 3.386, 95% CI 1.928–5.948; p<0.0001) as well as transient (HR 2.998, 95% CI 1.406–6.393; p=0.0045) DSAs were associated with shorter CLAD-free survival compared with patients without DSAs. Persistent DSAs (HR 3.071, 95% CI 1.632–5.778; p=0.0005) but not transient DSAs were negatively associated with graft survival compared with patients without DSAs, likely due to the higher incidence of restrictive CLAD. HLA non-DSAs and pre-transplant HLA antibodies had no effect on post-transplant outcome.We demonstrated an important difference in prognosis between persistent and transient DSAs. Moreover, the observed association between DSAs and restrictive CLAD suggests an overlap between antibody-mediated rejection and restrictive CLAD that needs further investigation.

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