February 23, 2012

Allosensitization and outcomes in pediatric heart transplantation


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Allosensitization of pediatric heart transplant candidates continues to be a problem with uncertainty on the best clinical approach to manage these patients. Using data from the Pediatric Heart Transplant Study, the current study examined >3000 patients listed for heart transplantation of which 2237 were transplanted with available panel reactive antibody (PRA) data. The outcomes for survival pre-transplant and survival post-transplant were compared among patients according to %PRA. Patients with ≥50% PRA showed the lowest transplant rates within 1 year on the waitlist compared to those with PRA <10%. Sensitized patients (≥50% PRA) also showed lower survival at 1 year post transplant but not if the patients were crossmatch negative at the time of transplant. PRA levels were not associated with time to first rejection or development of coronary allograft vasculopathy. Although not a novel message, this study does show conclusions from a large number of patients which is always limiting in individual studies of pediatric heart transplants.

Cardiac Transplantation

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