(1209) A Case of Dual Organ Lung-Kidney Transplant in a Highly Sensitized Patient
نویسندگان
چکیده
IntroductionAllosensitization presents a barrier to lung transplantation in otherwise acceptable patient candidates leading increased waitlist times and mortality. We present case of highly sensitized dual organ kidney-lung transplant recipient that did not develop AMR despite from positive crossmatch donor after treatment with an Eculizumab based protocol.Case ReportOur is 57-year-old woman idiopathic pulmonary arterial hypertension complicated by decompensated right heart failure resulting end stage renal requiring dialysis. She was evaluated for lung-kidney which revealed elevated PRAs (100, 22). The underwent multiple rounds desensitization including therapies consisting plasma exchange (PLEX), IVIG, Bortezomib, rATG were unsuccessful decreasing her PRA values. waitlisted ten months the ICU without offer. Given high probability mortality, risks benefits accepting discussed patient. Subsequently, crossmatch. To prevent hyperacute rejection, we implemented novel immunosuppression strategy peri- post-operative period (Figure). patient's post-op course vancomycin resistant enterococcal bacteremia candida fungemia. Post-operative DSA titers peaked on POD 14 (HLA-A*01:01; 1:64, HLA-C*07:01; 1:512), however subsequently down trended 100 1:16, 1:4). Surveillance spirometry at 6 remains stable when compared best.SummaryThis report describes rejection following experience some infectious complications but recovered well.
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ژورنال
عنوان ژورنال: Journal of Heart and Lung Transplantation
سال: 2023
ISSN: ['1053-2498', '1557-3117']
DOI: https://doi.org/10.1016/j.healun.2023.02.1419