{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:06:27Z","timestamp":1787504787524,"version":"build-2736575974"},"reference-count":31,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["FS\/19\/52\/34563"],"award-info":[{"award-number":["FS\/19\/52\/34563"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anti-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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Anti-HLA antibody-containing whole blood was added to a Cardiopulmonary bypass (CPB) circuit set up to mimic a 20\u00a0kg 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\u00a0min for the duration of treatment (total 180\u00a0min).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A reduction in individual allele median fluorescence intensity (MFI) to below clinically relevant levels (&lt;1000 MFI), and in the majority of cases below the lower positive detection limit (&lt;500 MFI), even in alleles with a baseline MFI &gt;4000 was demonstrated. Reduction occurred in all cases within 120\u00a0min, 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Intraoperative immunoadsorption in an ex vivo setting demonstrates clinically relevant reductions in anti-HLA antibodies within the normal timeframe for heart transplantation. This method represents a potential desensitization technique that could enable sensitized children to accept a donor organ earlier, even in the presence of donor-specific anti-HLA antibodies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591221151035","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T06:30:06Z","timestamp":1673332206000},"page":"543-554","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Rapid desensitization through immunoadsorption during cardiopulmonary bypass. A novel method to facilitate human leukocyte antigen incompatible heart transplantation"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6299-2557","authenticated-orcid":false,"given":"Richard W","family":"Issitt","sequence":"first","affiliation":[{"name":"Perfusion Department, Great Ormond Street Hospital for Children, London, UK"},{"name":"Institute of Cardiovascular Science, University College London, London, UK"},{"name":"Digital Research, Informatics and Virtual Environment, NIHR Great Ormond Street Biomedical Research Centre, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eamonn","family":"Cudworth","sequence":"additional","affiliation":[{"name":"Clinical Transplantation Laboratory, Barts Health NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Cortina-Borja","sequence":"additional","affiliation":[{"name":"Population, Policy and Practice Research and Teaching 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Hospital for Children, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0713-5165","authenticated-orcid":false,"given":"Alex","family":"Robertson","sequence":"additional","affiliation":[{"name":"Perfusion Department, Great Ormond Street Hospital for Children, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor T","family":"Tsang","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London, London, UK"},{"name":"Department of Cardiothoracic Surgery, Great Ormond Street Hospital for Children, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Henwood","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation, Great Ormond Street Hospital for Children, London, 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