Antibody-Mediated Rejection in Heart Transplantation: Case Presentation with a Review of Current International Guidelines
Antibody-mediated rejection (AMR) (humoral rejection) of cardiac allografts remains difficult to diagnose and treat. Interest in AMR of cardiac allografts has increased over the last decade as it has become apparent that untreated humoral rejection threatens graft and patient survival. An internatio...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2011-01-01
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| Series: | Journal of Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2011/351950 |
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| author | Octavio E. Pajaro Dawn E. Jaroszewski Robert L. Scott Anantharam V. Kalya Henry D. Tazelaar Francisco A. Arabia |
| author_facet | Octavio E. Pajaro Dawn E. Jaroszewski Robert L. Scott Anantharam V. Kalya Henry D. Tazelaar Francisco A. Arabia |
| author_sort | Octavio E. Pajaro |
| collection | DOAJ |
| description | Antibody-mediated rejection (AMR) (humoral rejection) of cardiac allografts remains difficult to diagnose and treat. Interest in AMR of cardiac allografts has increased over the last decade as it has become apparent that untreated humoral rejection threatens graft and patient survival. An international and multidisciplinary consensus group has formulated guidelines for the diagnosis and treatment of AMR and established that identification of circulating or donor-specific antibodies is not required and that asymptomatic AMR, that is, biopsy-proven AMR without cardiac dysfunction is a real entity with worsened prognosis. Strict criteria for the diagnosis of cardiac AMR have not been firmly established, although the diagnosis relies heavily on tissue pathological findings. Therapy remains largely empirical. We review an unfortunate experience with one of our patients and summarize recommended criteria for the diagnosis of AMR and potential treatment schemes with a focus on current limitations and the need for future research and innovation. |
| format | Article |
| id | doaj-art-b33e4c1e7dca4c0daf2778c9bd0bc5fb |
| institution | OA Journals |
| issn | 2090-0007 2090-0015 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Transplantation |
| spelling | doaj-art-b33e4c1e7dca4c0daf2778c9bd0bc5fb2025-08-20T02:23:27ZengWileyJournal of Transplantation2090-00072090-00152011-01-01201110.1155/2011/351950351950Antibody-Mediated Rejection in Heart Transplantation: Case Presentation with a Review of Current International GuidelinesOctavio E. Pajaro0Dawn E. Jaroszewski1Robert L. Scott2Anantharam V. Kalya3Henry D. Tazelaar4Francisco A. Arabia5Department of Surgery, Division of Cardiothoracic Surgery, Mayo Clinic Arizona, 5777 E. Mayo Boulevard, Phoenix, AZ 85054, USADepartment of Surgery, Division of Cardiothoracic Surgery, Mayo Clinic Arizona, 5777 E. Mayo Boulevard, Phoenix, AZ 85054, USADepartment of Medicine, Division of Cardiology, Mayo Clinic Arizona, 5777 E. Mayo Boulevard, Phoenix, AZ 85054, USADepartment of Medicine, Division of Cardiology, Mayo Clinic Arizona, 5777 E. Mayo Boulevard, Phoenix, AZ 85054, USADepartment of Laboratory Medicine and Pathology, Mayo Clinic Arizona, 5777 E. Mayo Boulevard, Phoenix, AZ 85054, USADepartment of Surgery, Division of Cardiothoracic Surgery, Mayo Clinic Arizona, 5777 E. Mayo Boulevard, Phoenix, AZ 85054, USAAntibody-mediated rejection (AMR) (humoral rejection) of cardiac allografts remains difficult to diagnose and treat. Interest in AMR of cardiac allografts has increased over the last decade as it has become apparent that untreated humoral rejection threatens graft and patient survival. An international and multidisciplinary consensus group has formulated guidelines for the diagnosis and treatment of AMR and established that identification of circulating or donor-specific antibodies is not required and that asymptomatic AMR, that is, biopsy-proven AMR without cardiac dysfunction is a real entity with worsened prognosis. Strict criteria for the diagnosis of cardiac AMR have not been firmly established, although the diagnosis relies heavily on tissue pathological findings. Therapy remains largely empirical. We review an unfortunate experience with one of our patients and summarize recommended criteria for the diagnosis of AMR and potential treatment schemes with a focus on current limitations and the need for future research and innovation.http://dx.doi.org/10.1155/2011/351950 |
| spellingShingle | Octavio E. Pajaro Dawn E. Jaroszewski Robert L. Scott Anantharam V. Kalya Henry D. Tazelaar Francisco A. Arabia Antibody-Mediated Rejection in Heart Transplantation: Case Presentation with a Review of Current International Guidelines Journal of Transplantation |
| title | Antibody-Mediated Rejection in Heart Transplantation: Case Presentation with a Review of Current International Guidelines |
| title_full | Antibody-Mediated Rejection in Heart Transplantation: Case Presentation with a Review of Current International Guidelines |
| title_fullStr | Antibody-Mediated Rejection in Heart Transplantation: Case Presentation with a Review of Current International Guidelines |
| title_full_unstemmed | Antibody-Mediated Rejection in Heart Transplantation: Case Presentation with a Review of Current International Guidelines |
| title_short | Antibody-Mediated Rejection in Heart Transplantation: Case Presentation with a Review of Current International Guidelines |
| title_sort | antibody mediated rejection in heart transplantation case presentation with a review of current international guidelines |
| url | http://dx.doi.org/10.1155/2011/351950 |
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