Immunosuppression in the sensitized heart transplant recipient

Peter M. Eckman

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations

Abstract

Purpose Of Review: The proportion of heart transplant candidates who are allosensitized has increased over time. Advances in tissue typing and immunosuppression have improved the rate of successful transplant in this challenging population. Recently published data regarding contemporary approaches to desensitization prior to and immunosuppression following transplant are summarized. Recent Findings: Continued progress in measurement and characterization of antibodies and strategies to abrogate antibody production both prior to and following heart transplant have been encouraging. Updates on the role of non-human leukocyte antigen antibodies and the impact of mechanical circulatory support on allosensitization are provided. Data on current desensitization strategies, including the increasing use of monoclonal antibodies, are provided and the potential role of complement inhibitors will be reviewed. Increasing experience with potent novel agents is likely to provide the opportunity to improve transplant outcomes for highly sensitized patients. Summary: Although allosensitized heart transplant candidates remain a management challenge, excellent outcomes can be achieved with contemporary approaches. Advances in the understanding of B-cell biology are anticipated to further broaden options and improve outcomes.

Original languageEnglish (US)
Pages (from-to)650-656
Number of pages7
JournalCurrent Opinion in Organ Transplantation
Volume15
Issue number5
DOIs
StatePublished - Oct 2010
Externally publishedYes

Keywords

  • alloimmunization
  • heart transplantation
  • immunosuppression
  • sensitized

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