title: Intentional ABO-incompatible heart transplantation: a case report of 2 adult patients.
abstract: BACKGROUND
  In 2009, we started to screen all patients on the heart transplant waiting list for the presence of blood group anti-A or anti-B antibodies. From our experience with ABO-incompatible kidney transplantation, we know that transplantation can safely be performed if the antibody level is reduced to a titer of immunoglobulin G (IgG) 1:8.
  
  
  METHODS
  We decided to accept all patients with anti-A or anti-B antibody titer ≤1:8 for ABO-incompatible heart transplantation without any special pre-treatment and patients with antibody titers of IgG 1:16 and 1:32, provided 1 apheresis session could be performed immediately before transplantation.
  
  
  RESULTS
  We found 6 of 13 patients were suitable for this program, and 2 ABO incompatible patients underwent successful transplantation with a follow-up of 1 year.
  
  
  CONCLUSIONS
  In heart transplant candidates where there are problems obtaining a compatible heart and who are not suitable for ventricular assist device support, ABO-incompatible heart transplantations can be considered using our protocol, provided that the levels of anti-A or anti-B antibodies are low.
authors.affiliation: Department of Transplantation Surgery, Karolinska University Hospital, Stockholm, Sweden. gunnar.tyden@karolinska.se
authors.forename: Gunnar
authors.initials: G
authors.lastname: Tydén
authors.forename: Inger
authors.initials: I
authors.lastname: Hagerman
authors.forename: Karl-Henrik
authors.initials: KH
authors.lastname: Grinnemo
authors.forename: Peter
authors.initials: P
authors.lastname: Svenarud
authors.forename: Jan
authors.initials: J
authors.lastname: van der Linden
authors.forename: Gunilla
authors.initials: G
authors.lastname: Kumlien
authors.forename: Annika
authors.initials: A
authors.lastname: Wernerson
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000368:Aged; D001787:Blood Group Incompatibility / Q000276:immunology*; D016027:Heart Transplantation / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000017:ABO Blood-Group System; D007074:Immunoglobulin G