Table 2:
PATIENT 1 | PATIENT 2 | PATIENT 3 | PATIENT 4 | PATIENT 5 | PATIENT 6 | PATIENT 7 | PATIENT 8 | PATIENT 9 | PATIENT 10 | PATIENT 11 | |
---|---|---|---|---|---|---|---|---|---|---|---|
Demographics | 11yo female 51kg |
14yo male 54kg |
10yo male 41kg |
4mo female 5kg |
4yo female 15kg |
8yo male 18.8kg |
6yo male 26kg |
12yo female 86.4kg |
15yo female 55kg |
7yo female 29kg |
12 yo female 57.8kg |
Pre-Transplant Diagnosis | Dilated Cardiomyopathy | Ischemic Cardiomyopathy | Restrictive Cardiomyopathy | Dilated cardiomyopathy | Myocarditis s/p OHT, graft failure | HLHS (MA/AA) | Dilated cardiomyopathy | Dilated cardiomyopathy | HLHS (MA/AA) | Dilated cardiomyopathy | Dilated cardiomyopathy |
Pre-Transplant Course | ECMO x 10 days, Heartware LVAD x 6 days | ECMO x 10 days, Heartware LVAD x 6 months | Heartware LVAD x 6 months | Berlin Heart LVAD x 5 weeks | ECMO x 25 days, Berlin Heart BiVAD x 3 months | Fontan | Heartware LVAD x 5 months | ECMO x 4 days, Heartware LVAD x 4 months | Fontan | HeartMate LVAD x 5 weeks | Heartware LVAD x 10 months |
Pre-TPE PRA | 0% | 27% | 97% | 0% | 72% | 68% | 24% | 65% | 0% | 11% | 0% |
Duration of Intraoperative TPE (min) | 136 | 80 | 45 | 50 | 21 | 40 | 40 | 59 | 49 | 47 | 62 |
Plasma Volumes Processed | 2.8 | 1.5 | 1.2 | 1.7 | 1.4 | 2.2 | 1.3 | 1.4 | 1.1 | 1.6 | 1.5 |
Transplant Crossmatch | B cell and T cell compatible, no DSAs | T cell compatible, B cell incompatible, no DSAs | B cell and T cell incompatible, weakly positive DSA (A23, B49) | T cell compatible, B cell compatible, no DSAs | T cell compatible, B cell incompatible, no DSAs | T cell compatible, B cell compatible, weakly positive DSA (A31, DR4) | T cell incompatible, B cell compatible, no DSAs | T cell compatible, B cell compatible, no DSAs | T cell compatible, B cell compatible, weakly positive DSA (A2) | T cell compatible, B cell compatible, no DSAs | T cell compatible, B cell compatible, no DSAs |
Additional TPE Performed | None | 6 | 4 | None | 5 | 8 | None | None | 3 | None | None |
Dates of Additional TPE | POD#1 – POD#6 | POD#1 – POD#5 | POD#1 – POD#5 | POD#19 – POD#22, POD#36-POD#38 | POD#13, 14, 16 | ||||||
Indication for Additional TPE | Weakly positive DSA (Bw6) on POD#4 | Positive crossmatch | 72% PRA | Antibody mediated rejection | Positive DSA (A2) | ||||||
Latest DSA | Negative 2 months post-transplant | Negative 37 months post-transplant | DQ8 (1:64) 39 months post-transplant | Negative 37 months post-transplant | Negative 5 days post-transplant | A31 (1:16), DR4 (1:64) 5 weeks post-transplant | Negative 12 months post-transplant | Negative 11 months post-transplant | Negative 7 months post-transplant | Negative 2 months post-transplant | Negative 1 month post-transplant |
Outcome | Deceased 2 months post-transplant due to pseudomonal sepsis | Doing well 4 years post-transplant | Stable chronic rejection 3 years post-transplant | Doing well 37 months post-transplant | Deceased 17 days post-transplant due to renal failure | Deceased 7 weeks post-transplant due to AMR | Doing well 14 months post-transplant | Doing well 1 year post-transplant | Doing well 10 months post-transplant | Doing well 4 months post-transplant | Doing well 1 month post-transplant |
Abbreviations: ECMO: extracorporeal membranous oxygenation, LVAD: left ventricular assist device, BiVAD: biventricular assist device, HLHS: hypoplastic left heart syndrome, MA/AA: mitral atresia/aortic atresia, TPE: therapeutic plasma exchange, PRA: panel reactive antibodies, DSA: donor specific antigen, AMR: antibody mediated rejection