Abstract
Management of heart transplant recipients with hemodynamically significant clinical rejection in the presence of antibodies against angiotensin II type 1 receptor: A retrospective study
Highlights
Heart transplantation is a lifesaving treatment for patients with end stage heart failure
Antibodies against the human leukocyte antigens (HLA) are known to play a dominant role in decreased graft survival [2] and treatments prior to and after transplantation are used for patients who present with HLA antibodies directed against donor antigens (HLA-DSA) [3]
Many centers report testing for presence of antibodies other than HLA when allograft dysfunction occurs in the absence of detectable HLA-DSA [4,5]; these include antibodies directed against the MHC class I polypeptiderelated sequence A [6], endothelin A receptor [7], vimentin and myosin
Summary
Heart transplantation is a lifesaving treatment for patients with end stage heart failure. After surviving the immediate perioperative period, early complications facing the cardiac transplant population include infection, graft rejection, and cardiac allograft vasculopathy (CAV). Antibodies against the human leukocyte antigens (HLA) are known to play a dominant role in decreased graft survival [2] and treatments prior to and after transplantation are used for patients who present with HLA antibodies directed against donor antigens (HLA-DSA) [3]. Many centers report testing for presence of antibodies other than HLA (non-HLA antibodies) when allograft dysfunction occurs in the absence of detectable HLA-DSA [4,5]; these include antibodies directed against the MHC class I polypeptiderelated sequence A [6], endothelin A receptor [7], vimentin and myosin [8]. Appropriate treatment approaches or outcomes posttreatment in the presence of non-HLA antibodies are not sufficiently described in the literature [3]
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