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ABO-incompatible heart transplantation: a perfusion strategy.
C Foreman1, C Gruenwald, L West
1Cardiovascular Perfusion Department, The Hospital for Sick Children, Toronto, Canada.
Perfusion
|April 10, 2004
Summary
Infants with fatal heart conditions can now receive transplants despite blood type differences. This innovative approach significantly reduces waiting list mortality by overcoming ABO incompatibility barriers.
Area of Science:
- Cardiology
- Immunology
- Transplantation Surgery
Background:
- Infants with fatal cardiac disease face high mortality rates due to donor heart shortages.
- Traditional heart transplantation requires ABO blood group compatibility, limiting the donor pool.
Purpose of the Study:
- To investigate the feasibility and outcomes of ABO-incompatible heart transplantation in infants.
- To reduce mortality rates among infants awaiting heart transplants by expanding donor options.
Main Methods:
- Implemented a modified cardiopulmonary bypass (CPB) technique to reduce anti-A and anti-B antibodies in infants.
- Performed ABO-incompatible heart transplants on 16 infants under 14 months of age.
- Utilized plasma depletion and reinfusion of packed red blood cells during CPB.
Main Results:
- Achieved an 87% survival rate in infants undergoing ABO-incompatible heart transplantation.
- Reduced the mortality rate of infants on the waiting list from 58% to 10%.
Conclusions:
- ABO-incompatible heart transplantation is a viable strategy to improve survival in infants with fatal cardiac disease.
- Infants' immunologic immaturity contributes to the success of ABO-incompatible transplants.
- Expanding heart transplantation beyond ABO compatibility can decrease waiting times and save lives.