Heart transplantation (HT) remains the preferred therapy for patients with advanced
heart failure. However, for sensitized HT candidates who have antibodies to human
leukocyte antigens , finding a suitable donor can be challenging and can lead to adverse
waitlist outcomes. In recent years, the number of sensitized patients awaiting HT
has increased likely due to the use of durable and mechanical circulatory support
as well as increasing number of candidates with underlying congenital heart disease.
This State-of-the-Art review discusses the assessment of human leukocyte antigens
antibodies, potential desensitization strategies including mechanisms of action and
specific protocols, the approach to a potential donor including the use of complement-dependent
cytotoxicity, flow cytometry, and virtual crossmatches, and peritransplant induction
management.
KEYWORDS
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Article info
Publication history
Published online: December 26, 2022
Publication stage
In Press Journal Pre-ProofIdentification
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© 2022 International Society for Heart and Lung Transplantation. All rights reserved.
