ABO-incompatible heart transplantation: crossing the immunological barrier

• Published in: Journal of cardiovascular medicine (Hagerstown, Md.) Vol. 9; no. 8; p. 854
• Main Authors: Gambino, Antonio, Torregrossa, Gianluca, Cozzi, Emanuele, Angelini, Annalisa, De Silvestro, Giustina, Cerutti, Alessia, Feltrin, Giuseppe, Toscano, Giuseppe, d'Agostino, Chiara, Zanella, Fabio, Thiene, Gaetano, Gerosa, Gino
• Format: Journal Article
• Language: English
• Published: United States 01.08.2008
• Subjects: ABO Blood-Group System - immunology; Adult; Biopsy; Blood Group Incompatibility - blood; Blood Group Incompatibility - immunology; Blood Group Incompatibility - therapy; Blood Transfusion - methods; Echocardiography; Fibroma - diagnosis; Fibroma - surgery; Follow-Up Studies; Graft Rejection - blood; Graft Rejection - immunology; Graft Rejection - prevention & control; Heart Neoplasms - diagnosis; Heart Neoplasms - surgery; Heart Transplantation - immunology; Heart Ventricles; Humans; Infant; Myocardium - pathology; Plasmapheresis - methods
• ISSN: 1558-2027
• DOI: 10.2459/JCM.0b013e3282f64233

Due to the shortage of organ donors, heart transplantation cannot be offered to many infants with end-stage heart failure; this issue leads to mortality rates of 30-50% in patients in the paediatric age group awaiting operation. ABO-incompatible heart transplantation has been performed safely with no particular or invasive preparatory procedures other than plasma exchange during cardiopulmonary bypass for removing preformed antibodies, with no reports of hyperacute rejection. We report our first clinical experience of heart transplantation on a 2-month-old-infant (blood group O), diagnosed with intracardiac tumour, in which the donor was a 19-day-old newborn of blood group A. Sharing the know-how about ABO-incompatible heart transplantation in newborns and infants awaiting transplantation will help in decreasing mortality among this group of patients.