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Report from a consensus conference on antibody-mediated rejection in heart transplantation.

Publication ,  Journal Article
Kobashigawa, J; Crespo-Leiro, MG; Ensminger, SM; Reichenspurner, H; Angelini, A; Berry, G; Burke, M; Czer, L; Hiemann, N; Kfoury, AG; Patel, J ...
Published in: J Heart Lung Transplant
March 2011

BACKGROUND: The problem of AMR remains unsolved because standardized schemes for diagnosis and treatment remains contentious. Therefore, a consensus conference was organized to discuss the current status of antibody-mediated rejection (AMR) in heart transplantation. METHODS: The conference included 83 participants (transplant cardiologists, surgeons, immunologists and pathologists) representing 67 heart transplant centers from North America, Europe, and Asia who all participated in smaller break-out sessions to discuss the various topics of AMR and attempt to achieve consensus. RESULTS: A tentative pathology diagnosis of AMR was established, however, the pathologist felt that further discussion was needed prior to a formal recommendation for AMR diagnosis. One of the most important outcomes of this conference was that a clinical definition for AMR (cardiac dysfunction and/or circulating donor-specific antibody) was no longer believed to be required due to recent publications demonstrating that asymptomatic (no cardiac dysfunction) biopsy-proven AMR is associated with subsequent greater mortality and greater development of cardiac allograft vasculopathy. It was also noted that donor-specific antibody is not always detected during AMR episodes as the antibody may be adhered to the donor heart. Finally, recommendations were made for the timing for specific staining of endomyocardial biopsy specimens and the frequency by which circulating antibodies should be assessed. Recommendations for management and future clinical trials were also provided. CONCLUSIONS: The AMR Consensus Conference brought together clinicians, pathologists and immunologists to further the understanding of AMR. Progress was made toward a pathology AMR grading scale and consensus was accomplished regarding several clinical issues.

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Published In

J Heart Lung Transplant

DOI

EISSN

1557-3117

Publication Date

March 2011

Volume

30

Issue

3

Start / End Page

252 / 269

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Humans
  • Heart Transplantation
  • Graft Rejection
  • Antibodies
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology
 

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Kobashigawa, J., Crespo-Leiro, M. G., Ensminger, S. M., Reichenspurner, H., Angelini, A., Berry, G., … Consensus Conference Participants, . (2011). Report from a consensus conference on antibody-mediated rejection in heart transplantation. J Heart Lung Transplant, 30(3), 252–269. https://doi.org/10.1016/j.healun.2010.11.003
Kobashigawa, Jon, Maria G. Crespo-Leiro, Stephan M. Ensminger, Hermann Reichenspurner, Annalisa Angelini, Gerald Berry, Margaret Burke, et al. “Report from a consensus conference on antibody-mediated rejection in heart transplantation.J Heart Lung Transplant 30, no. 3 (March 2011): 252–69. https://doi.org/10.1016/j.healun.2010.11.003.
Kobashigawa J, Crespo-Leiro MG, Ensminger SM, Reichenspurner H, Angelini A, Berry G, et al. Report from a consensus conference on antibody-mediated rejection in heart transplantation. J Heart Lung Transplant. 2011 Mar;30(3):252–69.
Kobashigawa, Jon, et al. “Report from a consensus conference on antibody-mediated rejection in heart transplantation.J Heart Lung Transplant, vol. 30, no. 3, Mar. 2011, pp. 252–69. Pubmed, doi:10.1016/j.healun.2010.11.003.
Kobashigawa J, Crespo-Leiro MG, Ensminger SM, Reichenspurner H, Angelini A, Berry G, Burke M, Czer L, Hiemann N, Kfoury AG, Mancini D, Mohacsi P, Patel J, Pereira N, Platt JL, Reed EF, Reinsmoen N, Rodriguez ER, Rose ML, Russell SD, Starling R, Suciu-Foca N, Tallaj J, Taylor DO, Van Bakel A, West L, Zeevi A, Zuckermann A, Consensus Conference Participants. Report from a consensus conference on antibody-mediated rejection in heart transplantation. J Heart Lung Transplant. 2011 Mar;30(3):252–269.
Journal cover image

Published In

J Heart Lung Transplant

DOI

EISSN

1557-3117

Publication Date

March 2011

Volume

30

Issue

3

Start / End Page

252 / 269

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Humans
  • Heart Transplantation
  • Graft Rejection
  • Antibodies
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology