Immunologic considerations in heart transplantation for congenital heart disease.
Children and adults with congenital heart disease (CHD) can require interventions that result in immunologic alterations that are different than those seen in patients with cardiomyopathies. Patients with CHD can be exposed to heart surgeries, blood products, valved and non-valved allograft tissue, and mechanical circulatory support, all of which can alter the immunologic status of these patients. This change in immunologic status is most commonly manifested as the development of anti-human leukocyte antigen (HLA) antibodies. This review will delineate a) the causes of anti-HLA anti-body production (often referred to as allosensitization); b) preventive strategies for anti-HLA antibody production before transplantation; c) treatment strategies for those patients who develop anti-HLA antibodies before transplantation; d) consequences of HLA allosensitization after transplantation; and e) treatment of HLA allosensitization and antibody-mediated rejection after transplantation.
['Kaufman|Beth D|BD|', 'Shaddy|Robert E|RE|']
D000906:Antibodies D002648:Child D003888:Desensitization, Immunologic D006084:Graft Rejection D006680:HLA Antigens D006330:Heart Defects, Congenital D006331:Heart Diseases D016027:Heart Transplantation D006801:Humans D007166:Immunosuppressive Agents D014181:Transplantation Immunology
Heart transplantation allosensitization rejection management. pediatric therapy