Management of the sensitized heart transplant candidate.

IF 1.8 4区 医学 Q3 TRANSPLANTATION Current Opinion in Organ Transplantation Pub Date : 2023-10-01 Epub Date: 2023-08-09 DOI:10.1097/MOT.0000000000001096
Michelle M Kittleson
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Abstract

Purpose of review: For sensitized heart transplant candidates who have antibodies to human leukocyte antigens (HLA), finding a suitable donor can be challenging and can lead to adverse waitlist outcomes. In recent years, the number of sensitized patients awaiting heart transplantation has increased likely due to the use of durable and mechanical circulatory support as well as increasing number of candidates with underlying congenital heart disease.

Recent findings: Advances in the assessment of HLA antibodies allow for identification of heart transplant candidates who may benefit from desensitization strategies to widen the donor pool and mitigate the risk of adverse posttransplant outcomes.

Summary: Antibody sensitization is a barrier to successful heart transplantation and strategies to identify sensitized patients, stratify their risk, and mitigate this risk through desensitization is crucial to optimize the quality of life and survival of HT recipients.

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致敏心脏移植候选者的管理。
综述目的:对于具有人类白细胞抗原(HLA)抗体的致敏心脏移植候选者来说,寻找合适的供体可能具有挑战性,并可能导致不良的等待名单结果。近年来,等待心脏移植的致敏患者数量增加,这可能是由于使用了持久的机械循环支持,以及患有潜在先天性心脏病的候选患者数量增加。最近的发现:HLA抗体评估的进展允许识别心脏移植候选者,这些候选者可能受益于脱敏策略,以扩大供体库并降低移植后不良结果的风险。总结:抗体致敏是心脏移植成功的障碍,识别致敏患者、对其风险进行分层并通过脱敏减轻这种风险的策略对于优化HT受体的生活质量和生存至关重要。
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来源期刊
CiteScore
4.10
自引率
4.50%
发文量
124
审稿时长
6-12 weeks
期刊介绍: ​​​​​​Current Opinion in Organ Transplantation is an indispensable resource featuring key, up-to-date and important advances in the field from around the world. Led by renowned guest editors for each section, every bimonthly issue of Current Opinion in Organ Transplantation delivers a fresh insight into topics such as stem cell transplantation, immunosuppression, tolerance induction and organ preservation and procurement. With 18 sections in total, the journal provides a convenient and thorough review of the field and will be of interest to researchers, surgeons and other healthcare professionals alike.
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