Before heart transplantation the serum of heart transplant candidates is tested for levels of anti-human leukocyte antigen (HLA) which could bind to donor HLA antigens and cause rejection of the organ. At the time of transplantation, a virtual crossmatch is conducted to determine if the patient's anti-HLA antibodies are directed against the donor's specific HLA antigen -- if yes, they are called "donor specific anti-HLA antibody" (DSA).
"Most centres do not perform heart transplantation in patients with a high DSA level since the risk of antibody-mediated rejection is high, particularly hyper-acute rejection," said lead author Dr Guillaume Coutance, a cardiologist at Pitié-Salpêtrière Hospital in Paris, France. "Patients then have to wait for a donor with different HLA antigens."
To reduce the chance of rejection in these patients at high immunological risk, in 2009 Pitié-Salpêtrière Hospital began a desensitisation programme. The current study analysed the impact of the programme on survival after heart transplantations performed during 2009 to 2015. Continue reading
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