Thymoglobulin induction in heart transplantation: patient selection and implications for maintenance immunosuppression
Standard
Thymoglobulin induction in heart transplantation: patient selection and implications for maintenance immunosuppression. / Zuckermann, Andreas; Schulz, Uwe; Deuse, Tobias; Ruhpawar, Arjang; Schmitto, Jan D; Beiras-Fernandez, Andres; Hirt, Stephan; Schweiger, Martin; Kopp-Fernandes, Laurenz; Barten, Markus J.
in: TRANSPL INT, Jahrgang 28, Nr. 3, 03.2015, S. 259-269.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Thymoglobulin induction in heart transplantation: patient selection and implications for maintenance immunosuppression
AU - Zuckermann, Andreas
AU - Schulz, Uwe
AU - Deuse, Tobias
AU - Ruhpawar, Arjang
AU - Schmitto, Jan D
AU - Beiras-Fernandez, Andres
AU - Hirt, Stephan
AU - Schweiger, Martin
AU - Kopp-Fernandes, Laurenz
AU - Barten, Markus J
N1 - © 2014 The Authors Transplant International published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT.
PY - 2015/3
Y1 - 2015/3
N2 - Clinical data relating to rabbit antithymocyte globulin (rATG) induction in heart transplantation are far less extensive than for other immunosuppressants, or indeed for rATG in other indications. This was highlighted by the low grade of evidence and the lack of detailed recommendations for prescribing rATG in the International Society for Heart and Lung Transplantation (ISHLT) guidelines. The heart transplant population includes an increasing frequency of patients on mechanical circulatory support (MCS), often with ongoing infection and/or presensitization, who are at high immunological risk but also vulnerable to infectious complications. The number of patients with renal impairment is also growing due to lengthening waiting times, intensifying the need for strategies that minimize calcineurin inhibitor (CNI) toxicity. Additionally, the importance of donor-specific antibodies (DSA) in predicting graft failure is influencing immunosuppressive regimens. In light of these developments, and in view of the lack of evidence-based prescribing criteria, experts from Germany, Austria, and Switzerland convened to identify indications for rATG induction in heart transplantation and to develop an algorithm for its use based on patient characteristics.
AB - Clinical data relating to rabbit antithymocyte globulin (rATG) induction in heart transplantation are far less extensive than for other immunosuppressants, or indeed for rATG in other indications. This was highlighted by the low grade of evidence and the lack of detailed recommendations for prescribing rATG in the International Society for Heart and Lung Transplantation (ISHLT) guidelines. The heart transplant population includes an increasing frequency of patients on mechanical circulatory support (MCS), often with ongoing infection and/or presensitization, who are at high immunological risk but also vulnerable to infectious complications. The number of patients with renal impairment is also growing due to lengthening waiting times, intensifying the need for strategies that minimize calcineurin inhibitor (CNI) toxicity. Additionally, the importance of donor-specific antibodies (DSA) in predicting graft failure is influencing immunosuppressive regimens. In light of these developments, and in view of the lack of evidence-based prescribing criteria, experts from Germany, Austria, and Switzerland convened to identify indications for rATG induction in heart transplantation and to develop an algorithm for its use based on patient characteristics.
KW - Animals
KW - Antilymphocyte Serum/immunology
KW - Graft Rejection/immunology
KW - Heart Transplantation
KW - Humans
KW - Immune Tolerance
KW - Immunosuppression/methods
KW - Immunosuppressive Agents/therapeutic use
KW - Rabbits
U2 - 10.1111/tri.12480
DO - 10.1111/tri.12480
M3 - SCORING: Review article
C2 - 25363471
VL - 28
SP - 259
EP - 269
JO - TRANSPL INT
JF - TRANSPL INT
SN - 0934-0874
IS - 3
ER -
