Olivia N Gilbert1, Patricia P Chang1. 1. University of North Carolina at Chapel Hill, Division of Cardiology, Department of Medicine, Chapel Hill, NC.
Abstract
A PURPOSE OF REVIEW: This review summarizes recent data about antibodies after cardiac transplantation; what testing modalities are available and how frequently to employ them; as well as when treatment is necessary. B RECENT FINDINGS: Technologies available for antibody detection have progressed over the past couple decades. New and preformed antibodies are associated with worse outcomes in transplant recipients. C SUMMARY: The frequency of screening for post-transplant antibodies and for antibody-mediated rejection (AMR) should be based on risk stratification. The presence of antibodies alone post-transplant does not constitute a diagnosis of AMR. Treatment of post-transplant antibodies and AMR should be made in conjunction with consideration of AMR grade and graft dysfunction. Future directions will involve improved detection methods and further understanding of non-HLA antibodies and de novo antibodies in the post-transplant population. Additionally, aggressive efforts are currently underway to provide more therapeutic options.
A PURPOSE OF REVIEW: This review summarizes recent data about antibodies after cardiac transplantation; what testing modalities are available and how frequently to employ them; as well as when treatment is necessary. B RECENT FINDINGS: Technologies available for antibody detection have progressed over the past couple decades. New and preformed antibodies are associated with worse outcomes in transplant recipients. C SUMMARY: The frequency of screening for post-transplant antibodies and for antibody-mediated rejection (AMR) should be based on risk stratification. The presence of antibodies alone post-transplant does not constitute a diagnosis of AMR. Treatment of post-transplant antibodies and AMR should be made in conjunction with consideration of AMR grade and graft dysfunction. Future directions will involve improved detection methods and further understanding of non-HLA antibodies and de novo antibodies in the post-transplant population. Additionally, aggressive efforts are currently underway to provide more therapeutic options.
Authors: Jon A Kobashigawa; Jignesh K Patel; Michelle M Kittleson; Matt A Kawano; Krista K Kiyosaki; Stephanie N Davis; Jaime D Moriguchi; Elaine F Reed; Abbas A Ardehali Journal: Clin Transplant Date: 2010-10-25 Impact factor: 2.863
Authors: Susan Stewart; Gayle L Winters; Michael C Fishbein; Henry D Tazelaar; Jon Kobashigawa; Jacki Abrams; Claus B Andersen; Annalisa Angelini; Gerald J Berry; Margaret M Burke; Anthony J Demetris; Elizabeth Hammond; Silviu Itescu; Charles C Marboe; Bruce McManus; Elaine F Reed; Nancy L Reinsmoen; E Rene Rodriguez; Alan G Rose; Marlene Rose; Nicole Suciu-Focia; Adriana Zeevi; Margaret E Billingham Journal: J Heart Lung Transplant Date: 2005-06-20 Impact factor: 10.247
Authors: Elaine F Reed; Anthony J Demetris; Elizabeth Hammond; Silviu Itescu; Jon A Kobashigawa; Nancy L Reinsmoen; E Rene Rodriguez; Marlene Rose; Susan Stewart; Nicole Suciu-Foca; Adriana Zeevi; Michael C Fishbein Journal: J Heart Lung Transplant Date: 2006-02 Impact factor: 10.247
Authors: Eric K Ho; George Vlad; Elena Rodica Vasilescu; Ludwika de la Torre; Adriana I Colovai; Elizabeth Burke; Mario Deng; Joseph Schwartz; Charles Marboe; Donna Mancini; Gerhard Opelz; Nicole Suciu-Foca Journal: Hum Immunol Date: 2010-11-10 Impact factor: 2.850
Authors: Akan Emin; Chris A Rogers; Joyce Thekkudan; Robert S Bonser; Nicholas R Banner Journal: J Heart Lung Transplant Date: 2011-03-27 Impact factor: 10.247