Treatment of Donor-specific Antibody-mediated Rejection After Heart Transplantation by IgM-enriched Human Immunoglobulin

Overview

Journal ESC Heart Fail

Date 2021 May 10

PMID 33969938

Citations 2

Authors

Moritz Benjamin Immohr

Payam Akhyari

Hug Aubin

Ralf Westenfeld

Arash Mehdiani

Raphael Romano Bruno

Nihat Firat Sipahi

Sophiko Erbel-Khurtsidze

Petra Reinecke

Igor Tudorache

Artur Lichtenberg

Udo Boeken

Affiliations

Soon will be listed here.

Abstract

Antibody-mediated graft rejection caused by donor-specific antibodies (DSA-MR) remains a serious problem after heart transplantation (HTx). IgM-enriched human intravenous immunoglobulin (IGM-IVIG) consists of 76% IgG, 12% IgM, and 12% IgA and provides a new multifactorial approach for DSA-MR. Between 2017 and 2020, four (P1-4) of 102 patients developed DSA-MR after HTx in our department and were repetitively treated with IGM-IVIG in combination with anti-thymocyte globulin. While in P1 and P4, DSA-MR occurred within the early post-operative interval, P2 and P3 developed DSA-MR approximately 1 year after transplantation. An impairment of ventricular function was observed in three of four patients. Furthermore, P1 and P4 suffered from malign ventricular arrhythmias. After the application of IGM-IVIG, the ventricular function recovered, and all patients could be discharged from the hospital. As part of a multifactorial therapeutic approach, treatment with IGM-IVIG seems to be a safe and effective strategy to address DSA-MR.

Citing Articles

IgM-enriched immunoglobulin as adjuvant therapy for heart transplant after infection of left ventricular assist devices.

Immohr M, Bottger C, Aubin H, Westenfeld R, Oehler D, Bruno R ESC Heart Fail. 2022; 9(5):3630-3635.

PMID: 35854478 PMC: 9715847. DOI: 10.1002/ehf2.14074.

Treatment of donor-specific antibody-mediated rejection after heart transplantation by IgM-enriched human immunoglobulin.

Immohr M, Akhyari P, Aubin H, Westenfeld R, Mehdiani A, Bruno R ESC Heart Fail. 2021; 8(4):3413-3417.

PMID: 33969938 PMC: 8318410. DOI: 10.1002/ehf2.13409.

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