{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T01:53:24Z","timestamp":1788314004871,"version":"build-2803163510"},"reference-count":15,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"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":["Pediatric Transplantation"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anti\u2010HLA sensitization is associated with antibody\u2010mediated rejection and represents a major challenge to successful heart transplantation. Daratumumab, an IgG\u03ba monoclonal antibody targeting the CD38 receptor on plasma cells, was initially developed for the treatment of multiple myeloma. In transplantation, it may help reduce antibody production by inducing plasma cell apoptosis. Its use in heart transplantation has been limited, particularly in pediatric patients, with only two cases reported in the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Since 2020, four heart transplant recipients at CHU Sainte\u2010Justine developed donor\u2010specific antibodies (DSAs) and were treated with daratumumab intravenously (16\u2009mg\/kg once a week for a minimum of 6\u2009weeks) for desensitization prior to heart transplantation or for the treatment of antibody\u2010mediated rejection. Their medical records were thoroughly analyzed (e.g., DSA levels, biopsy results) to assess the efficacy and safety of daratumumab treatment in four individual case studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three patients received daratumumab for antibody\u2010mediated rejection, and one received it as part of a desensitization protocol prior to heart transplantation. DSAs became undetectable in three of the patients. Despite this clearance, one died 18\u2009months after treatment from coronary artery disease while awaiting a second transplant. In the fourth patient, a young adult with both cellular and antibody\u2010mediated rejection, treatment was ineffective despite two cycles. No major side effects were reported during or after daratumumab treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In all treated patients, Daratumumab was well tolerated, with no major adverse effects except for secondary hypogammaglobulinemia. It may play a key role in managing acute antibody\u2010mediated rejection and desensitizing highly sensitized pediatric transplant recipients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70166","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T10:10:26Z","timestamp":1758103826000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Daratumumab in Heart Transplantation: A Pilot Study in a Pediatric and Young Adult Series"],"prefix":"10.1111","volume":"29","author":[{"given":"Robert S.","family":"Tuta","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology CHU Sainte\u2010Justine Hospital University Centre  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabien","family":"Touzot","sequence":"additional","affiliation":[{"name":"Division of Immunology CHU Sainte\u2010Justine Hospital University Centre  Montreal Quebec Canada"},{"name":"Research Centre CHU Sainte\u2010Justine Hospital University Centre  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nassiba Alami","family":"Laroussi","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology CHU Sainte\u2010Justine Hospital University Centre  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxime","family":"Tremblay\u2010Gravel","sequence":"additional","affiliation":[{"name":"Cardiac Transplantation Montreal Heart Institute, University of Montreal  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Tremblay","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology CHU Sainte\u2010Justine Hospital University Centre  Montreal Quebec 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Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.70166","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T09:36:56Z","timestamp":1762940216000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.70166"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,17]]},"references-count":15,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/petr.70166"],"URL":"https:\/\/doi.org\/10.1111\/petr.70166","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"value":"1397-3142","type":"print"},{"value":"1399-3046","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,17]]},"assertion":[{"value":"2025-05-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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