{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T23:10:08Z","timestamp":1740179408666,"version":"3.37.3"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,1,27]],"date-time":"2020-01-27T00:00:00Z","timestamp":1580083200000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"German Research Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]},{"name":"DFG"},{"DOI":"10.13039\/501100002714","name":"Albert Ludwigs University Freiburg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002714","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,2,1]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Antibody-mediated rejection (AMR) in cardiac transplantation may manifest early within the first weeks after transplantation but also late after months to years following transplantation resulting in mild heart failure to cardiogenic shock. While patients with early cardiac AMR are less affected and seem to have survival rates comparable to transplant recipients without AMR, late cardiac AMR is frequently associated with graft dysfunction, fulminant forms of cardiac allograft vasculopathy, and a high mortality rate. Nevertheless, AMR of cardiac allografts remains difficult to diagnose and to treat.<\/jats:p>\n <\/jats:sec>\n \n Case summary<\/jats:title>\n We report the case of a 47-year-old male patient with late AMR of the cardiac allograft 3\u2009years after heart transplantation. Antibody-mediated rejection was confirmed by endomyocardial biopsy and the presence of donor-specific antibodies (DSA). The patient was treated with high dose of prednisolone, plasmapheresis, intravenous Gamma Globulin, rituximab, immunoadsorption, and bortezomib. Under this treatment regimen left ventricular ejection fraction and pro B-type natriuretic peptide recovered, and the patient improved to New York Heart Association Class I. Currently, 3\u2009years after the diagnosis of cardiac AMR, graft function continues to be nearly normal, and there is no evidence for transplant vasculopathy.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n This case illustrates that AMR can occur at any time after transplantation. Although graft function fully recovered after treatment in our patient, the level of DSA remained high, suggesting that DSA may not be a reliable parameter to determine the intensity and duration of the therapy.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytz246","type":"journal-article","created":{"date-parts":[[2020,1,26]],"date-time":"2020-01-26T23:56:56Z","timestamp":1580083016000},"page":"1-4","source":"Crossref","is-referenced-by-count":1,"title":["Antibody-mediated rejection with detection of de novo donor-specific anti-human leucocyte antigen Class II antibodies 3 years after heart transplantation: a case report"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2300-6416","authenticated-orcid":false,"given":"Bernd","family":"Ludwig","sequence":"first","affiliation":[{"name":"Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0661-6984","authenticated-orcid":false,"given":"Johanna","family":"Schneider","sequence":"first","affiliation":[{"name":"Department of Nephrology, Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"F\u00f6ll","sequence":"first","affiliation":[{"name":"Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1828-4879","authenticated-orcid":false,"given":"Qian","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,1,25]]},"reference":[{"key":"2020022804014115600_ytz246-B1","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1161\/CIR.0000000000000093","article-title":"Antibody-mediated rejection in cardiac transplantation: emerging knowledge in diagnosis and management: a scientific statement from the American Heart Association","volume":"131","author":"Colvin","year":"2015","journal-title":"Circulation"},{"key":"2020022804014115600_ytz246-B2","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1016\/j.healun.2015.03.002","article-title":"Late antibody-mediated rejection after heart transplantation: Mortality, graft function, and fulminant cardiac allograft vasculopathy","volume":"34","author":"Coutance","year":"2015","journal-title":"J Heart Lung Transplant"},{"key":"2020022804014115600_ytz246-B3","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1016\/j.healun.2016.04.007","article-title":"The effect of timing and graft dysfunction on survival and cardiac allograft vasculopathy in antibody-mediated rejection","volume":"35","author":"Clerkin","year":"2016","journal-title":"J Heart Lung Transplant"},{"key":"2020022804014115600_ytz246-B4","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1016\/j.healun.2004.09.003","article-title":"Treatment of vascular rejection with rituximab in cardiac transplantation","volume":"24","author":"Garrett","year":"2005","journal-title":"J Heart Lung Transplant"},{"key":"2020022804014115600_ytz246-B5","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1097\/MOT.0b013e3282f6391e","article-title":"Accommodation in organ transplantation","volume":"13","author":"Lynch","year":"2008","journal-title":"Curr Opin Organ Transplant"}],"container-title":["European Heart Journal - 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