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| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Artículo Open Access |
| Published: |
Wiley
2024
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| Online Access: | https://onlinelibrary.wiley.com/doi/10.1111/ctr.15249 |
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Table of Contents:
- Effectiveness of combined plasma cell therapy and costimulation blockade based desensitization regimen in heart transplant candidates Nadia Fida Todd N. Eagar Allison N. Yun Alex W. Rogers Duc T. Nguyen Edward A. Graviss Farhan Ishaq Nicholas R. DiPaola Ju Kim Gorthi Janardhana Mahwash Kassi Rayan Yousefzai Eric E. Suarez Arvind Bhimaraj Jill C. Krisl Ashrith Guha Clinical Transplantation AbstractBackgroundDesensitization is one of the strategies to reduce antibodies and facilitate heart transplantation in highly sensitized patients. We describe our center's desensitization experience with combination of plasma cell (PC) depletion therapy (with proteasome inhibitor or daratumumab) and costimulation blockade (with belatacept).MethodsWe reviewed five highly sensitized patients who underwent desensitization therapy with plasma cell depletion and costimulation blockade. We evaluated the response to therapy by measuring the changes in cPRA, average MFI, and number of positive beads > 5000MFI.ResultsFive patients, mean age of 56 (37‐66) years with average cPRA of 98% at 5000 MFI underwent desensitization therapy. After desensitization, mean cPRA decreased from 98% to 70% (p = .09), average number of beads > 5000 MFI decreased from 59 to 37 (p = .15), and average MFI of beads > 5000 MFI decreased from 16713 to 13074 (p = .26).ConclusionCombined PC depletion and CoB could be a reasonable strategy for sustained reduction in antibodies in highly sensitized patients being listed for heart transplantation. 10.1111/ctr.15249 http://onlinelibrary.wiley.com/termsAndConditions#vor