Exchange transfusion during extra corporeal membrane oxygenation used as a bridge to ABO-mismatch cardiac transplantation.
We report a case in which exchange transfusion was performed directly from the extracorporeal membrane oxygenation circuit in a child being bridged to cardiac transplantation. This allowed preparation for ABO-mismatched heart transplant in a child dependent on extracorporeal support, awaiting a suitable ABO-matched donor. Exchange transfusion or plasmapheresis in this setting would normally be performed on cardiopulmonary bypass to allow exsanguinations under hypothermia immediately pre-transplant. This allows little time for depletion of isohemagglutinins, occasionally leading to prolonged bypass times. We believe our method to be a safe alternative, allowing ample time for immunological preparation for ABO-incompatible transplant.
Department of Cardiothoracic Surgery and Transplantation, Freeman Hospital, High Heaton, Newcastle upon Tyne, United Kingdom. phil.botha@nuth.northy.nhs.uk
Phil
P
Botha
Asif
A
Hasan
Simon
S
Haynes
Jane
J
Cassidy
Joe
J
Roe
John
J
Wallis
Jon
J
Smith
D000017:ABO Blood-Group System; D001787:Blood Group Incompatibility; D004452:Echocardiography; D004569:Electroencephalography; D005078:Exchange Transfusion, Whole Blood; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods; D016027:Heart Transplantation / Q000276:immunology* / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D016343:Monitoring, Intraoperative; D016896:Treatment Outcome
D000017:ABO Blood-Group System