In:
Pediatric Transplantation, Wiley, Vol. 17, No. 7 ( 2013-11), p. 661-669
Abstract:
Sensitization to HLA is a risk factor for adverse outcomes after heart transplantation. Requiring a negative prospective CM results in longer waiting times and increased waitlist mortality. We report outcomes in a cohort of sensitized children who underwent transplant despite a positive CDC CM + using a protocol of antibody depletion at time of transplant, followed by serial IVIG administration. All patients 〈 21 yrs old who underwent heart transplantation at Boston Children's Hospital from 1/1998 to 1/2011 were included. We compared freedom from allograft loss, allograft rejection, and serious infection between CM + and CM − recipients. Of 134 patients in the cohort, 33 (25%) were sensitized prior to transplantation and 12 (9%) received a CM + heart transplant. Serious infection in the first post‐transplant year was more prevalent in the CM + patients compared with CM − patients (50% vs. 16%; p = 0.005), as was HD‐AMR (50% vs. 2%; p 〈 0.001). There was no difference in freedom from allograft loss or any rejection. At our center, children transplanted despite a positive CM had acceptable allograft survival and risk of any rejection, but a higher risk of HD‐AMR and serious infection.
Type of Medium:
Online Resource
ISSN:
1397-3142
,
1399-3046
DOI:
10.1111/petr.2013.17.issue-7
Language:
English
Publisher:
Wiley
Publication Date:
2013
detail.hit.zdb_id:
2008614-3
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