Long‐term benefits of immunoadsorption in β1‐adrenoceptor autoantibody‐positive transplant candidates with dilated cardiomyopathy

摘要: Aims Prolongation of waiting times for heart transplantation (HTx) increases the need new therapies. In short-term follow-up studies, immunoadsorption (IA) appeared beneficial in dilated cardiomyopathy (DCM) associated with β1-adrenoreceptor-autoantibodies (β1-AABs). This study aimed to investigate long-term benefits IA HTx candidates DCM, patients' responsiveness IA, and impact β1-AAB removal on results. Methods results In a single-centre retrospective prospectively gathered information we evaluated all β1-AAB-positive -negative end-stage DCM [left ventricular ejection fraction (LVEF) <30%] who underwent between 1995 2005 (follow-up thereafter: 5.3–14.7 years). As controls used patients referred during same time period received no therapy. We also looked differences efficacy unspecific (unselective antibody removal) specific (selective removal). The main outcome measures were cardiac function HTx/ventricular assist device (VAD)-free patient survival. probability 5-year HTx/VAD-free survival the108 reached 69.4 ± 4.4% was significantly higher (P < 0.05) than both without (25.4 11.4%) β1-AAB-negative (47.4 11.5). high levels, showed efficiency removal. LVEF New York Heart Assocation class improved 0.01) after both, but improvement or IA. prevalence responders similar (78.3% vs. 79.6%). 76% reappearance, redetection AABs coincided worsening function. Conclusions Removal β1-AABs by can improve allowing stability which spare many from will delay listing years. be these antibodies.