{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T08:17:02Z","timestamp":1773735422607,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T00:00:00Z","timestamp":1609286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Donor\u2010specific antibodies (DSAs) in patients prior to heart transplantation are associated with increased risk of rejection and can lead to longer waitlist times, but it is not known whether patients with low\/moderate\u2010level DSA at transplant have acceptable post\u2010transplant outcomes. We performed a single\u2010center, retrospective review to examine outcomes associated with crossing pre\u2010existing low\/moderate\u2010level DSA. We assessed 864 patients awaiting heart transplantation between 2010 and 2018, identified 67 patients with low\/moderate\u2010level DSA and compared them to patients who were sensitized without DSA at the time of heart transplantation, as well as a control group of non\u2010sensitized patients. Outcomes included 3\u2010year survival, freedom from cardiac allograft vasculopathy (CAV), freedom from non\u2010fatal major adverse cardiac events (NF\u2010MACE), and 1\u2010year freedom from rejection. In the first\u2010year post\u2010transplant, there was decreased freedom from antibody\u2010mediated rejection (AMR) in the patients with pre\u2010existing DSA compared with patients sensitized without DSA and non\u2010sensitized patients. However, the DSA group experienced similar 3\u2010year post\u2010transplant survival, freedom from CAV, and freedom from NF\u2010MACE compared with the other study groups. Our findings suggest that crossing low\/moderate\u2010level DSA does not lead to worse outcomes in heart transplantation and may offer a viable way to increase a sensitized patient's chance to obtain a suitable donor.<\/jats:p>","DOI":"10.1111\/ctr.14196","type":"journal-article","created":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T21:41:29Z","timestamp":1608327689000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Crossing low\/moderate\u2010level donor\u2010specific antibodies during heart transplantation"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2369-4407","authenticated-orcid":false,"given":"Gayatri","family":"Setia","sequence":"first","affiliation":[{"name":"Smidt Heart Institute Cedars\u2010Sinai Medical Center Los Angeles CA 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Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9308-3172","authenticated-orcid":false,"given":"Jon","family":"Kobashigawa","sequence":"additional","affiliation":[{"name":"Smidt Heart Institute Cedars\u2010Sinai Medical Center Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2017.02.015"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-200010150-00011"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2010.03383.x"},{"issue":"3","key":"e_1_2_8_5_1","first-page":"229","article-title":"Donor\u2010specific HLA alloantibodies: long\u2010term impact on cardiac allograft vasculopathy and mortality after heart transplant","volume":"6","author":"Kaczmarek I","year":"2008","journal-title":"Exp 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