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(1108) New Desensitization Strategy: Daratumumab for Highly Sensitized Pediatric Heart Transplant Candidate by N. Baez Hernandez; L. Radel; R. Butts; M. Bano; J. Lantz; R. Davies; C. Lacelle; T. Ellimuttil is a Medicine article available to read on EtoBox.

What is (1108) New Desensitization Strategy: Daratumumab for Highly Sensitized Pediatric Heart Transplant Candidate about?

Introduction Allosensitization represents a barrier to successful heart transplant (HT). It increases waitlist (WL) mortality and may lead to inferior post-transplant outcomes. Strategies to reduce the number of circulating antibodies are utilized with little data on effectiveness of specific desensitization approaches in pediatric HT candidates. We present a case utilizing daratumumab, a monoclonal anti-CD38 antibody, for desensitization in a pediatric patient. Case Report A 13 month old girl with large intracardiac fibroma was evaluated for HT and found to have significant complement fixing class II HLA antibodies (cPRA 99%) precluding HT. Based on the constellation of heart failure symptoms and expected WL time, decision was made to proceed to VAD support as a bridge to decision and facilitate desensitization. Initial desensitization therapy included plasmapheresis, rituximab, bortezomib, and IVIG, failed to reduce preformed class II HLA antibodies (cPRA remained 99%) and several class II antibodies remained C1q positive. Subsequent desensitization included rituximab, bortezomib and the addition of daratumumab. After receiving 6 doses of daratumumab, the repeat cPRA decreased to

Who reads (1108) New Desensitization Strategy: Daratumumab for Highly Sensitized Pediatric Heart Transplant Candidate?

Author

N. Baez Hernandez; L. Radel; R. Butts; M. Bano; J. Lantz; R. Davies; C. Lacelle; T. Ellimuttil

Publisher

Elsevier BV

Published

2023

Language

EN

Field

Medicine (Health Sciences)