Shin Lin, Ioannis Dimarakis, Elina Minami, Ramasamy Bakthavatsalam, Renuka Bhattacharya, April Stempien-Otero, Yiing Lin, Aris Karatasakis, Maziar Khorsandi, Elaine Chou-Wu, Idoia Gimferrer, Mariya Y Golub, Daniel Fishbein, Richard K Cheng, Ryutaro Hirose, Mark Sturdevant, Jay D Pal
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Highly sensitized patients listed for heart after liver transplantation with or without domino.
For patients with end-stage heart disease and borderline hemodynamics, high human leukocyte antigen allosensitization presents a barrier to heart transplantation in a timely manner. Conventional desensitization protocols are inadequate in this context due to time constraints and for the most highly reactive immunologically. We previously reported performing heart after liver transplant with domino liver transplant on a single patient without liver disease. We describe this patient's course to date as well as 4 subsequent patients listed for this novel therapy. This experience demonstrates that the liver effectively confers immunoprotection to the heart for patients with high-titer, preformed antibodies. This strategy may provide some measure of equity for demographic groups previously disadvantaged for heart transplantation due to allosensitization.
期刊介绍：
The Journal of Heart and Lung Transplantation, the official publication of the International Society for Heart and Lung Transplantation, brings readers essential scholarly and timely information in the field of cardio-pulmonary transplantation, mechanical and biological support of the failing heart, advanced lung disease (including pulmonary vascular disease) and cell replacement therapy. Importantly, the journal also serves as a medium of communication of pre-clinical sciences in all these rapidly expanding areas.
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