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Current Research: Cardiology

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Experience with cellular and antibody mediated rejection after heart transplantation

Author(s): Ivan Málek*, Tomáš Gazdic, Markéta Hegarová, Lud ek Voska, Libuše Pagácová, Josef Kautzner and Jan Pirk

Objectives: To evaluate celluar and antibody mediated rejection in a group of patients after heart transplantation (HTX), performed in the authors’ institution during a six-year period.

Method: A retrospective analysis of patients surviving ≥12 months after HTX was performed. Rejection was evaluated from the samples obtained during endomyocardial biopsy, and graft function was assessed using echocardiography. The duration of follow-up ranged from 12 to 72 months.

Results: In the 196 patients evaluated, 65 treated episodes of cellular rejection were recorded in 50 patients, with significant reduction on tacrolimus prophylaxis. Antibody mediated rejection occured in 5.6% of patients, and was complicated by graft dysfunction in 64%.

Conclusion: Contemporary immunosuppressive prophylaxis decreases the frequency of cellular rejection, allowing modification of endomyocardial biopsy schedule. Antibody mediated rejection is a relatively rare but clinically important complication after HTX, and necessitates combined agressive therapy.

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