Key result
Heart transplant ACR and AMR therapies rely largely on extrapolated data from other solid organs.
Why the study?
Despite advances in posttransplant care, acute cellular rejection and antibody-mediated rejection remain major challenges causing allograft failure and mortality, with many challenges existing in traditional immunosuppressive therapies.
This review outlines current strategies and challenges in managing acute cellular and antibody-mediated rejection in heart transplant recipients, emphasizing the need for cardiac-specific therapeutic trials.
Extrapolated regimens warrant caution in heart transplant rejection; leaves open optimal cardiac-specific strategies.
Heart transplantation for patients with end-stage heart failure refractory to medical therapy has remained definitive treatment with significant advances in posttransplant care. Despite improvement in postoperative morbidity and mortality, acute cellular rejection (ACR) and antibody-mediated rejection (AMR) remain substantial challenges that can lead to allograft failure and patient mortality. Immunosuppressive agents have been the mainstay of both prevention and treatment for ACR and AMR; however, many challenges exist with traditional therapies. There are a multitude of molecular pathways involved in mediating the humoral and cellular response to rejection, offering various targets for treatment. This review summarizes therapies used in the management of ACR and AMR as extrapolated from use in induction therapy and treatment of other solid-organ transplant rejection. Future studies focused on cardiac transplant recipients are needed to expand therapeutic options.
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Patail et al. (2023) conducted a review in Cardiac allograft rejection (acute cellular and antibody-mediated rejection). Immunosuppressive therapies was evaluated. Immunosuppressive therapies for acute cellular and antibody-mediated rejection in heart transplantation are largely extrapolated from other solid-organ transplants, highlighting a need for future trials.
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