The Thoracic and Cardiovascular Surgeon · 1998 · 25 citations · 0 references
MedicineCardiologyPharmacologyCardiac TransplantationTransplant ImmunologyTransplant PharmacotherapyAcute RejectionHeart FailureHeart Transplant EvaluationHeart TransplantationImmunosuppression ManagementTransplant RejectionAdverse Drug ResponseAntibodiesImmunosuppressive Drug TherapyLeft Ventricular Assist Device TherapyLeft Ventricular Assist DevicesMycophenolate-based ImmunosuppressionPanel Reactive AntibodiesPretransplant Cardiac Evaluation
"Panel Reactive Antibody" (PRA) testing is commonly used to assess the pretransplant antibody status in order to estimate the risk of an adverse humoral response following transplantation. We report on a female patient with end-stage cardiac failure suffering from acute myocarditis who underwent implantation of a left-ventricular assist device (Novacor, Baxter Healthcare Corp. Oakland, CA). During evaluation for heart transplantation, a PRA level of 50-70% was detected. After treatment with mycophenolate mofetil at a dosage of 2 g daily, PRA levels declined within one week to 0-5%, and remained low after discontinuation of the immunosuppressive drug. We feel that pretreatment of patients with elevated PRA levels with mycophenolate mofetil is well justified.