Highly sensitized patients listed for heart after liver transplantation with or without domino.

IF 6.4 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Heart and Lung Transplantation Pub Date : 2025-01-01 Epub Date: 2024-08-31 DOI:10.1016/j.healun.2024.08.024
Shin Lin, Ioannis Dimarakis, Elina Minami, Ramasamy Bakthavatsalam, Renuka Bhattacharya, April Stempien-Otero, Yiing Lin, Aris Karatasakis, Maziar Khorsandi, Elaine Chou-Wu, Idoia Gimferrer, Mariya Y Golub, Daniel Fishbein, Richard K Cheng, Ryutaro Hirose, Mark Sturdevant, Jay D Pal
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Abstract

For patients with end-stage heart disease and borderline hemodynamics, high human leukocyte antigen allosensitization presents a barrier to heart transplantation in a timely manner. Conventional desensitization protocols are inadequate in this context due to time constraints and for the most highly reactive immunologically. We previously reported performing heart after liver transplant with domino liver transplant on a single patient without liver disease. We describe this patient's course to date as well as 4 subsequent patients listed for this novel therapy. This experience demonstrates that the liver effectively confers immunoprotection to the heart for patients with high-titer, preformed antibodies. This strategy may provide some measure of equity for demographic groups previously disadvantaged for heart transplantation due to allosensitization.

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肝脏移植后,高度敏感的患者在使用或不使用多米诺的情况下被列入心脏移植名单。
对于患有终末期心脏病和血液动力学不佳的患者来说,高度的 HLA 异体敏感性是及时进行心脏移植的障碍。在这种情况下,由于时间限制,传统的脱敏方案对于免疫反应最强烈的患者是不够的。我们曾报道过对一名无肝病的患者进行了多米诺肝移植(HALT-D)后心脏移植。我们介绍了这名患者迄今为止的病程,以及随后四名接受这种新疗法的患者的情况。这一经验表明,对于具有高滴度预形成抗体的患者,肝脏能有效地为心脏提供免疫保护。这一策略可在一定程度上为以前因异体敏感而在心脏移植中处于不利地位的人口群体提供公平性。
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来源期刊
CiteScore
10.10
自引率
6.70%
发文量
1667
审稿时长
69 days
期刊介绍: The Journal of Heart and Lung Transplantation, the official publication of the International Society for Heart and Lung Transplantation, brings readers essential scholarly and timely information in the field of cardio-pulmonary transplantation, mechanical and biological support of the failing heart, advanced lung disease (including pulmonary vascular disease) and cell replacement therapy. Importantly, the journal also serves as a medium of communication of pre-clinical sciences in all these rapidly expanding areas.
期刊最新文献
Long-term air pollution exposure and the risk of primary graft dysfunction after lung transplantation. Local intragraft humoral immune responses in chronic lung allograft dysfunction. Trends in heart transplant outcomes for patients over the age of 70 years in the United States: An analysis of the scientific registry of transplant recipients database. Highly sensitized patients listed for heart after liver transplantation with or without domino. Clinical outcomes after a biopsy diagnosis of antibody-mediated rejection in pediatric heart transplant recipients.
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