Pushing the boundaries: the current status of ABO-incompatible cardiac transplantation.
Since the introduction of intentional ABO-incompatible (ABOi) cardiac transplantation in infants in the late 1990's, the number of patients listed for and undergoing ABOi transplants has increased. This practice has been shown to lead to a reduction in waiting list mortality and increased utilisation of donor organs with equivalent outcomes to ABO-compatible transplants. Differences in the infant immune system provide a window of opportunity for ABOi transplantation. However it is increasingly clear that older patients and those with significant amounts of blood group antibody specific isohaemagglutinins may also benefit. Newer research is now focussing on longer term outcomes of ABOi transplants - in particular the development of graft accommodation or tolerance. This review assesses the current status of ABO-incompatible cardiac transplantation both in infants and in sensitized and older patients.
Department of Paediatric Cardiothoracic Transplantation, Freeman Hospital, Newcastle upon Tyne, UK. claire.irving@nuth.nhs.uk
Claire
C
Irving
Andrew
A
Gennery
Richard
R
Kirk
D000017:ABO Blood-Group System / Q000276:immunology*; D001787:Blood Group Incompatibility / Q000276:immunology*; D002170:Canada; D016027:Heart Transplantation / Q000276:immunology* / Q000639:trends*; D006388:Hemagglutinins / Q000097:blood; D006801:Humans; D023001:Transplantation Tolerance / Q000276:immunology; D006113:United Kingdom; D014481:United States; D014850:Waiting Lists
D000017:ABO Blood-Group System; D006388:Hemagglutinins