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Clinical approach to antibody-mediated rejection from the pediatric heart transplant society

Shahnawaz Amdani1, Heather Henderson2, Melanie D Everitt3

  • 1Pediatric Heart Failure and Transplant Cardiologist, Cleveland Clinic Children's Hospital, Cleveland, Ohio, USA.

Pediatric Transplantation
|November 15, 2022
PubMed

Insights

This guide defines, diagnoses, and treats antibody-mediated rejection (AMR) in pediatric heart transplant recipients. It offers a practical approach for managing AMR in children after heart transplantation.

Area of Science:

  • Pediatric Cardiology
  • Transplant Immunology
  • Immunosuppression Management

Background:

  • Antibody-mediated rejection (AMR) is a significant complication following pediatric heart transplantation.
  • Early diagnosis and effective management of AMR are crucial for long-term graft survival.
  • Current understanding and standardized approaches to pediatric AMR require further synthesis.

Approach:

  • A literature review was conducted by the Pediatric Heart Transplant Society (PHTS) working group.
  • Data on AMR diagnosis and management were collected from PHTS participating centers.
  • This document synthesizes existing literature and expert consensus for a practical approach.

Key Points:

  • Definition, pathogenesis, and diagnostic modalities for pediatric AMR are outlined.
  • Therapeutic strategies for managing AMR in children post-heart transplant are discussed.
  • Highlights a practical, evidence-based approach to AMR diagnosis and treatment.

Conclusions:

  • This document provides a foundational understanding for diagnosing and managing pediatric AMR.
  • It serves as a starting point for clinicians facing AMR in heart transplant recipients.
  • Emphasizes the need for a systematic approach to improve outcomes in pediatric heart transplantation.
Abstract

Keywords:
AMRheart transplantpediatric

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