Husain Majid, Butler Carrie, Fan Ashley M, Halnon Nancy J, Reardon Leigh C, Alejos Juan C
Division of Pediatric Cardiology, Department of Pediatrics, UCLA Mattel Children's Hospital, Los Angeles, California.
Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, UCLA Immunogenetics Center, Los Angeles, California.
JHLT Open. 2025 Jul 17;10:100346. doi: 10.1016/j.jhlto.2025.100346. eCollection 2025 Nov.
Allosensitization remains a significant obstacle for highly sensitized pediatric heart transplant candidates and recipients, particularly in the era of complex congenital heart disease palliations. Current desensitization strategies are limited, have variable efficacy, and lack durable response. Daratumumab, a monoclonal antibody targeting CD38 which is highly present on plasma cells and natural killer cells, is a novel and emerging option that has been successfully used for desensitization before heart transplantation in adults and to treat antibody-mediated rejection in solid organ recipients. However, there are limited data of its use in the pediatric population. We present our institution's complete experience with daratumumab in 4 highly sensitized patients with reasonable tolerability and encouraging response.
对于高度致敏的小儿心脏移植候选者和接受者而言，同种致敏仍然是一个重大障碍，尤其是在复杂先天性心脏病姑息治疗的时代。当前的脱敏策略有限，疗效各异，且缺乏持久反应。达雷妥尤单抗是一种靶向浆细胞和自然杀伤细胞上高度表达的CD38的单克隆抗体，是一种新兴的新选择，已成功用于成人心脏移植前的脱敏治疗以及实体器官接受者抗体介导的排斥反应的治疗。然而，其在儿科人群中的使用数据有限。我们介绍了我们机构在4例高度致敏患者中使用达雷妥尤单抗的完整经验，患者耐受性良好，反应令人鼓舞。
