Authors
- Korina Goluza – School of Medicine, University of Zagreb, Zagreb, Croatia; Clinic of Anesthesiology and Intensive Care, University Hospital Centre Zagreb, Zagreb, Croatia
- Sanja Konošić – School of Medicine, University of Zagreb, Zagreb, Croatia; Clinic of Anesthesiology and Intensive Care, University Hospital Centre Zagreb, Zagreb, Croatia
DOI
https://doi.org/10.65241/wh.8.2.10
Article type:
Review
Abstract:
Desensitization plays a key role in improving the outcomes of heart transplantation in sensitized patients, who otherwise face prolonged waiting times and an increased risk of rejection and graft failure. We present the case of a woman who developed severe cardiomyopathy after treatment for breast cancer. As transplantation was initially contraindicated due to recent malignancy, she was maintained on mechanical circulatory support. Following remission, she became eligible for transplantation but was identified as highly sensitized. Following a three-year wait for heart transplantation, the multidisciplinary team approved the initiation of a desensitization protocol, which was subsequently followed by heart transplantation upon allocation of a compatible organ.
The procedure was complicated by early graft dysfunction and bleeding, requiring temporary extracorporeal support. The patient underwent a tailored desensitization protocol, which was applied throughout the perioperative course. Nevertheless, the patient recovered well, with preserved graft function, minimal rejection on biopsy, and remained clinically stable during follow-up. In this case report, we present a highly sensitized patient who underwent successful heart transplantation after an extensive desensitization protocol.
Keywords:
Heart transplantation, anti-HLA antibodies, sensitization, desensitization.