Pediatric heart transplantation across ABO blood type barriers: a case study.
Heart transplantation with ABO blood type-incompatible donors has historically been contraindicated because of the high risk of an immediate hyperacute humoral graft rejection. The immature neonatal immune system presents an immunologic window that allows for breaching the ABO barrier before the natural development of anti-ABO antibodies. Information from a small series of neonates has demonstrated similar survival rates and posttransplant outcomes compared to ABO-compatible transplantations. In the posttransplant period, particular attention is placed on the surveillance of graft-specific antibody production and monitoring for immunologic signs and symptoms of early graft vasculopathy. This article presents a case study of a neonate with congenital heart disease who underwent one of the first successful ABO-incompatible heart transplantations in the United States.
Rodriguez
Rose J
RJ
Children's Hospital of New York-Presbyterian, New York, NY, USA.
Addonizio
Linda J
LJ
Lamour
Jacqueline M
JM
Mital
Seema
S
Mosca
Ralph
R
West
Lori J
LJ
Nova
Jenny C
JC
Hsu
Daphne T
DT
D000017:ABO Blood-Group System; D000359:Aftercare / Q000379:methods; D001787:Blood Group Incompatibility / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D001788:Blood Grouping and Crossmatching / Q000379:methods; D046148:Donor Selection / Q000379:methods*; D006084:Graft Rejection / Q000209:etiology / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival; D016027:Heart Transplantation / Q000009:adverse effects / Q000276:immunology* / Q000706:statistics & numerical data; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000150:complications / Q000276:immunology / Q000601:surgery; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007231:Infant, Newborn / Q000276:immunology; D008297:Male; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D012307:Risk Factors; D014181:Transplantation Immunology; D016896:Treatment Outcome
D000017:ABO Blood-Group System; D007166:Immunosuppressive Agents