Board Certification Review 2023 Spotlight: Cardiac Transplantation-Immunology and Rejection Presentations Q&A

Video Transcription

Video Summary

In this video, Dr. Sean Pinney discusses various topics related to heart transplantation. He mentions that there is no standardized threshold for interpreting immune studies and MFI (mean fluorescence intensity) cutoffs can vary widely between different HLA labs. He also mentions that photophoresis, a treatment for refractory rejection, is not widely available and still somewhat controversial. He discusses the challenges of interpreting conflicting evidence, such as a high DSA (donor-specific antibodies) but low cell-free DNA and no rejection on biopsy. He states that the use of cell-free DNA testing is still evolving and not yet established as standard of care. He also talks about the controversy surrounding the management of patients with high DSAs but no symptoms or allograft dysfunction. He mentions the Silex assay for monitoring immune suppression, but states it is not widely accepted. He discusses the role of desensitization and the threshold for considering it, which is still debated among centers. Lastly, he mentions non-HLA antibodies and their role in antibody-mediated rejection, as well as the commercial assays for cell-free DNA and their differences. <br /><br />No credits were mentioned in the video transcript.

Meta Tag

Immunology and Rejection immunosuppression

Immunology and Rejection prednisone

Immunology and Rejection calcineurin inhibitors

Immunology and Rejection cyclosporine

Immunology and Rejection tacrolimus

Immunology and Rejection antimetabolites

Immunology and Rejection azathioprine

Immunology and Rejection mycophenolate mofetil

Immunology and Rejection poliferation signal inhibitors

Immunology and Rejection sirolimus

Immunology and Rejection everolimus

Immunology and Rejection ISHLT guidelines

Immunology and Rejection corticosteriods

Immunology and Rejection Tac

Immunology and Rejection cyclo

Immunology and Rejection TIC TAC

Immunology and Rejection AZA/MMF

Immunology and Rejection PSIs

Immunology and Rejection MMF/PSI

Immunology and Rejection nephrotoxicity

Immunology and Rejection physiology

Immunology and Rejection afferents

Immunology and Rejection efferents

Immunology and Rejection medication responses

Immunology and Rejection interactions

Immunology and Rejection drug-drug

Keywords

heart transplantation

immune studies

MFI cutoffs

photophoresis

refractory rejection