Acute Antibody‐Mediated Rejection Following Heart Transplantation
Acute antibody‐mediated rejection (AMR) in heart transplantation is often associated with hemodynamic compromise, and is associated with increased mortality and development of accelerated transplant coronary artery disease (TCAD). The diagnosis of AMR has historically been controversial and outcomes...
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| Veröffentlicht in: | American journal of transplantation 2007-09, Vol.7 (9), p.2064-2074 |
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| container_issue | 9 |
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| container_title | American journal of transplantation |
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| creator | Uber, W. E. Self, S. E. Van Bakel, A. B. Pereira, N. L. |
| description | Acute antibody‐mediated rejection (AMR) in heart transplantation is often associated with hemodynamic compromise, and is associated with increased mortality and development of accelerated transplant coronary artery disease (TCAD). The diagnosis of AMR has historically been controversial and outcomes with aggressive immunosuppressive therapy including plasmapheresis and cyclophosphamide are poor. Advances in diagnostic techniques like the demonstration of immunopathologic evidence for antibody‐mediated rejection by deposition of the complement split product C4d in tissue and detection of anti‐HLA antibodies by flow cytometry will assist in further characterizing AMR. Immunosuppression targeting B‐lymphocytes and use of m‐TOR inhibitors to alter the predilection to develop TCAD and improve survival in AMR remains to be proven.
AMR is increasingly recognized as an important cause of morbidity and mortality in heart transplantation but treatment strategies must now be developed. |
| doi_str_mv | 10.1111/j.1600-6143.2007.01900.x |
| format | Article |
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AMR is increasingly recognized as an important cause of morbidity and mortality in heart transplantation but treatment strategies must now be developed.</description><identifier>ISSN: 1600-6135</identifier><identifier>EISSN: 1600-6143</identifier><identifier>DOI: 10.1111/j.1600-6143.2007.01900.x</identifier><identifier>PMID: 17614978</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Acute Disease ; Antibodies, Anti-Idiotypic - immunology ; Antibody‐mediated rejection ; Antigen-Antibody Complex - immunology ; Biological and medical sciences ; Cardiology. Vascular system ; complications ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - epidemiology ; Coronary Artery Disease - immunology ; Coronary heart disease ; diagnosis ; Flow Cytometry ; Graft Rejection - diagnosis ; Graft Rejection - epidemiology ; Graft Rejection - immunology ; Heart ; heart transplantation ; Heart Transplantation - immunology ; HLA-A Antigens - immunology ; Humans ; Immunoglobulin G - immunology ; Immunoglobulin M - immunology ; Immunohistochemistry ; immunosuppressive therapy ; Incidence ; Medical sciences ; Risk Factors ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; transplant coronary artery disease</subject><ispartof>American journal of transplantation, 2007-09, Vol.7 (9), p.2064-2074</ispartof><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4940-89732f38a406dbb274fc30d5015b4a9ebc933c64c64433a347120e2aa16b44743</citedby><cites>FETCH-LOGICAL-c4940-89732f38a406dbb274fc30d5015b4a9ebc933c64c64433a347120e2aa16b44743</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1600-6143.2007.01900.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1600-6143.2007.01900.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19021353$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17614978$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Uber, W. E.</creatorcontrib><creatorcontrib>Self, S. E.</creatorcontrib><creatorcontrib>Van Bakel, A. B.</creatorcontrib><creatorcontrib>Pereira, N. L.</creatorcontrib><title>Acute Antibody‐Mediated Rejection Following Heart Transplantation</title><title>American journal of transplantation</title><addtitle>Am J Transplant</addtitle><description>Acute antibody‐mediated rejection (AMR) in heart transplantation is often associated with hemodynamic compromise, and is associated with increased mortality and development of accelerated transplant coronary artery disease (TCAD). The diagnosis of AMR has historically been controversial and outcomes with aggressive immunosuppressive therapy including plasmapheresis and cyclophosphamide are poor. Advances in diagnostic techniques like the demonstration of immunopathologic evidence for antibody‐mediated rejection by deposition of the complement split product C4d in tissue and detection of anti‐HLA antibodies by flow cytometry will assist in further characterizing AMR. Immunosuppression targeting B‐lymphocytes and use of m‐TOR inhibitors to alter the predilection to develop TCAD and improve survival in AMR remains to be proven.
AMR is increasingly recognized as an important cause of morbidity and mortality in heart transplantation but treatment strategies must now be developed.</description><subject>Acute Disease</subject><subject>Antibodies, Anti-Idiotypic - immunology</subject><subject>Antibody‐mediated rejection</subject><subject>Antigen-Antibody Complex - immunology</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>complications</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Coronary Artery Disease - epidemiology</subject><subject>Coronary Artery Disease - immunology</subject><subject>Coronary heart disease</subject><subject>diagnosis</subject><subject>Flow Cytometry</subject><subject>Graft Rejection - diagnosis</subject><subject>Graft Rejection - epidemiology</subject><subject>Graft Rejection - immunology</subject><subject>Heart</subject><subject>heart transplantation</subject><subject>Heart Transplantation - immunology</subject><subject>HLA-A Antigens - immunology</subject><subject>Humans</subject><subject>Immunoglobulin G - immunology</subject><subject>Immunoglobulin M - immunology</subject><subject>Immunohistochemistry</subject><subject>immunosuppressive therapy</subject><subject>Incidence</subject><subject>Medical sciences</subject><subject>Risk Factors</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>transplant coronary artery disease</subject><issn>1600-6135</issn><issn>1600-6143</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkUtOwzAQQC0EouVzBZQN7BLGn9rxgkVVUQoqQkJlbTmOg1KlSYlTtd1xBM7ISXBo1C7BGskjzRt79AahAEOE_bmdR5gDhBwzGhEAEQGWANHmCPX3heN9Tgc9dObcHAALEpNT1MPCE1LEfTQamlVjg2HZ5EmVbr8_v55tmuvGpsGrnVvT5FUZjKuiqNZ5-R5MrK6bYFbr0i0LXTa6rV-gk0wXzl529zl6G9_PRpNw-vLwOBpOQ8MkgzCWgpKMxpoBT5OECJYZCukA8CBhWtrESEoNZz4YpZoygQlYojXmCWOC0XN0s3t3WVcfK-satcidsYUfxFYrp3iMuYwl_xMkwMQAU-zBeAeaunKutpla1vlC11uFQbWm1Vy1ElUrVLWm1a9ptfGtV90fq2Rh00Njp9YD1x2gndFF5p2Z3B04CcRvhnrubset88Ju_z2AGj7N2oz-AK6cmIw</recordid><startdate>200709</startdate><enddate>200709</enddate><creator>Uber, W. E.</creator><creator>Self, S. E.</creator><creator>Van Bakel, A. B.</creator><creator>Pereira, N. L.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>200709</creationdate><title>Acute Antibody‐Mediated Rejection Following Heart Transplantation</title><author>Uber, W. E. ; Self, S. E. ; Van Bakel, A. B. ; Pereira, N. L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4940-89732f38a406dbb274fc30d5015b4a9ebc933c64c64433a347120e2aa16b44743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Acute Disease</topic><topic>Antibodies, Anti-Idiotypic - immunology</topic><topic>Antibody‐mediated rejection</topic><topic>Antigen-Antibody Complex - immunology</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>complications</topic><topic>Coronary Artery Disease - diagnosis</topic><topic>Coronary Artery Disease - epidemiology</topic><topic>Coronary Artery Disease - immunology</topic><topic>Coronary heart disease</topic><topic>diagnosis</topic><topic>Flow Cytometry</topic><topic>Graft Rejection - diagnosis</topic><topic>Graft Rejection - epidemiology</topic><topic>Graft Rejection - immunology</topic><topic>Heart</topic><topic>heart transplantation</topic><topic>Heart Transplantation - immunology</topic><topic>HLA-A Antigens - immunology</topic><topic>Humans</topic><topic>Immunoglobulin G - immunology</topic><topic>Immunoglobulin M - immunology</topic><topic>Immunohistochemistry</topic><topic>immunosuppressive therapy</topic><topic>Incidence</topic><topic>Medical sciences</topic><topic>Risk Factors</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>transplant coronary artery disease</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Uber, W. E.</creatorcontrib><creatorcontrib>Self, S. E.</creatorcontrib><creatorcontrib>Van Bakel, A. B.</creatorcontrib><creatorcontrib>Pereira, N. L.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Uber, W. E.</au><au>Self, S. E.</au><au>Van Bakel, A. B.</au><au>Pereira, N. L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acute Antibody‐Mediated Rejection Following Heart Transplantation</atitle><jtitle>American journal of transplantation</jtitle><addtitle>Am J Transplant</addtitle><date>2007-09</date><risdate>2007</risdate><volume>7</volume><issue>9</issue><spage>2064</spage><epage>2074</epage><pages>2064-2074</pages><issn>1600-6135</issn><eissn>1600-6143</eissn><abstract>Acute antibody‐mediated rejection (AMR) in heart transplantation is often associated with hemodynamic compromise, and is associated with increased mortality and development of accelerated transplant coronary artery disease (TCAD). The diagnosis of AMR has historically been controversial and outcomes with aggressive immunosuppressive therapy including plasmapheresis and cyclophosphamide are poor. Advances in diagnostic techniques like the demonstration of immunopathologic evidence for antibody‐mediated rejection by deposition of the complement split product C4d in tissue and detection of anti‐HLA antibodies by flow cytometry will assist in further characterizing AMR. Immunosuppression targeting B‐lymphocytes and use of m‐TOR inhibitors to alter the predilection to develop TCAD and improve survival in AMR remains to be proven.
AMR is increasingly recognized as an important cause of morbidity and mortality in heart transplantation but treatment strategies must now be developed.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>17614978</pmid><doi>10.1111/j.1600-6143.2007.01900.x</doi><tpages>11</tpages></addata></record> |
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| ispartof | American journal of transplantation, 2007-09, Vol.7 (9), p.2064-2074 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Acute Disease Antibodies, Anti-Idiotypic - immunology Antibody‐mediated rejection Antigen-Antibody Complex - immunology Biological and medical sciences Cardiology. Vascular system complications Coronary Artery Disease - diagnosis Coronary Artery Disease - epidemiology Coronary Artery Disease - immunology Coronary heart disease diagnosis Flow Cytometry Graft Rejection - diagnosis Graft Rejection - epidemiology Graft Rejection - immunology Heart heart transplantation Heart Transplantation - immunology HLA-A Antigens - immunology Humans Immunoglobulin G - immunology Immunoglobulin M - immunology Immunohistochemistry immunosuppressive therapy Incidence Medical sciences Risk Factors Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases transplant coronary artery disease |
| title | Acute Antibody‐Mediated Rejection Following Heart Transplantation |
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