The sensitized pediatric heart transplant candidate: Causes, consequences, and treatment options
Robert E. Shaddy, Thomas C. Fuller,
Thomas C. Fuller
Pathology, University of Utah School of Medicine and Primary Children's Medical Center, Salt Lake City, UT, USA
Search for more papers by this authorRobert E. Shaddy, Thomas C. Fuller,
Thomas C. Fuller
Pathology, University of Utah School of Medicine and Primary Children's Medical Center, Salt Lake City, UT, USA
Search for more papers by this authorRobert E. Shaddy, MD, Cardiology, Suite 1500, Primary Children's Medical Center, 100 North Medical Drive, Salt Lake City, UT 84113, USA
Tel.: 801 588 2600
Fax: 801 588 2612
E-mail: [email protected]
Abstract
Abstract: Sensitization to HLA antigens and the subsequent development of HLA antibodies in children under consideration for heart transplantation is a significant impediment to survival after listing. This is related both to the frequent need for prospective donor-specific crossmatching (thus limiting donor availability and increasing pretransplant morbidity and mortality), and to the increased risk of adverse outcomes after transplantation. This article will review the scope of this problem in children under consideration for heart transplantation, the different methods available for diagnosing HLA sensitization, the known causes of HLA sensitization, the consequences of these preformed antibodies on outcomes before and after heart transplantation, and the different methods of preventing and treating this sensitization that are currently available. Improved methods of diagnosing, preventing, and treating this problem can only lead to better outcomes for children who require heart transplantation.
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