Evidence map›Paper›PMID 36625378›Full record

ArticlePerfusion2024

Rapid desensitization through immunoadsorption during cardiopulmonary bypass. A novel method to facilitate human leukocyte antigen incompatible heart transplantation.

Richard W Issitt, Eamonn Cudworth, Mario Cortina-Borja, Arun Gupta, Delordson Kallon, Richard Crook, Michael Shaw, Alex Robertson, Victor T Tsang, Sophie Henwood and 4 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Perfusion, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 44% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 3 institutions in 1 country.

Richard W IssittPerfusion Department, Great Ormond Street Hospital for Children, London, UK.ORCID 0000-0002-6299-2557
Eamonn CudworthClinical Transplantation Laboratory, Barts Health NHS Trust, London, UK.
Mario Cortina-BorjaPopulation, Policy and Practice Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, London, UK.
Arun GuptaClinical Transplantation Laboratory, Barts Health NHS Trust, London, UK.
Delordson KallonClinical Transplantation Laboratory, Barts Health NHS Trust, London, UK.
Richard CrookPerfusion Department, Great Ormond Street Hospital for Children, London, UK.ORCID 0000-0001-6782-1581
Michael ShawPerfusion Department, Great Ormond Street Hospital for Children, London, UK.
Alex RobertsonPerfusion Department, Great Ormond Street Hospital for Children, London, UK.ORCID 0000-0002-0713-5165
Victor T TsangInstitute of Cardiovascular Science, University College London, London, UK.
Sophie HenwoodDepartment of Cardiothoracic Transplantation, Great Ormond Street Hospital for Children, London, UK.
Vivek MuthuranguInstitute of Cardiovascular Science, University College London, London, UK.
Neil J SebireDigital Research, Informatics and Virtual Environment, NIHR Great Ormond Street Biomedical Research Centre, London, UK.
Michael BurchInstitute of Cardiovascular Science, University College London, London, UK.
Matthew FentonDepartment of Cardiothoracic Transplantation, Great Ormond Street Hospital for Children, London, UK.
Great Ormond Street Hospital · GBBarts Health NHS Trust · GBUniversity College London · GB

Funding

British Heart Foundation FS/19/52/34563
6 · The paper itself

Abstract

backgroundAnti-human leukocyte antigen (HLA)-antibody production represents a major barrier to heart transplantation, limiting recipient compatibility with potential donors and increasing the risk of complications with poor waiting-list outcomes. Currently there is no consensus to when desensitization should take place, and through what mechanism, meaning that sensitized patients must wait for a compatible donor for many months, if not years. We aimed to determine if intraoperative immunoadsorption could provide a potential desensitization methodology.

methodsAnti-HLA antibody-containing whole blood was added to a Cardiopulmonary bypass (CPB) circuit set up to mimic a 20 kg patient undergoing heart transplantation. Plasma was separated and diverted to a standalone, secondary immunoadsorption system, with antibody-depleted plasma returned to the CPB circuit. Samples for anti-HLA antibody definition were taken at baseline, when combined with the CPB prime (on bypass), and then every 20 min for the duration of treatment (total 180 min).

resultsA reduction in individual allele median fluorescence intensity (MFI) to below clinically relevant levels (<1000 MFI), and in the majority of cases below the lower positive detection limit (<500 MFI), even in alleles with a baseline MFI >4000 was demonstrated. Reduction occurred in all cases within 120 min, demonstrating efficacy in a time period usual for heart transplantation. Flowcytometric crossmatching of suitable pseudo-donor lymphocytes demonstrated a change from T cell and B cell positive channel shifts to negative, demonstrating a reduction in binding capacity.

conclusionsIntraoperative immunoadsorption in an

Indexed as

Heart TransplantationKidney TransplantationCardiopulmonary BypassChildHLA AntigensHumansTissue DonorsHLA Antigenscardiopulmonary bypasshuman leukocyte antigenimmunoadsorptionpaediatrictransplantation

Identifiers

PMID36625378
PMCPMC10943618
OpenAlexW4313908999

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.