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Successful management of antibody-mediated rejection after cardiac transplantation in a patient supported by a left ventricular assist device for more than 3 years

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Abstract

Due to donor shortage, patients with refractory heart failure need to be supported on mechanical circulatory support (MCS). Critically, patients undergo several deployments of MCS in stages inevitably requiring blood products transfusion. MCSs per se along with blood products can trigger immune allosensitization. Antibody-mediated rejection (AMR) is associated with significant mortality after heart transplantation. Here, we present the case with high panel-reactive antibody over 95% who developed AMR early after heart transplantation. This life-threatening complication was successfully treated with multi-modal treatment including anti-CD20 antibody, rituximab.

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Authors and Affiliations

  1. Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan

    Masatoshi Akiyama, Shingo Takahara, Satoshi Kawatsu, Osamu Adachi, Kiichiro Kumagai, Shunsuke Kawamoto & Yoshikatsu Saiki

  2. Physiological Laboratory Center, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan

    Yoichi Endo & Junko Fujiwara

Authors
  1. Masatoshi Akiyama
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  2. Shingo Takahara
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  3. Satoshi Kawatsu
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  4. Yoichi Endo
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  5. Junko Fujiwara
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  6. Osamu Adachi
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  7. Kiichiro Kumagai
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  8. Shunsuke Kawamoto
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  9. Yoshikatsu Saiki
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Corresponding author

Correspondence to Masatoshi Akiyama.

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Akiyama, M., Takahara, S., Kawatsu, S. et al. Successful management of antibody-mediated rejection after cardiac transplantation in a patient supported by a left ventricular assist device for more than 3 years. Gen Thorac Cardiovasc Surg 65, 710–712 (2017). https://doi.org/10.1007/s11748-017-0763-3

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  • DOI: https://doi.org/10.1007/s11748-017-0763-3

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