ABO-incompatible hearts for infant transplantation

  title={ABO-incompatible hearts for infant transplantation},
  author={Lori J. West},
  journal={Current Opinion in Organ Transplantation},
  • L. West
  • Published 1 October 2011
  • Medicine
  • Current Opinion in Organ Transplantation
Purpose of reviewThe practice of offering ABO-incompatible (ABOi) heart transplantation during infancy was initiated based on the rationale that infants are at the highest risk of dying while waiting for a transplant, yet are at low risk of hyperacute antibody-mediated rejection due to immunologic immaturity. Since the first report of intentional ABOi heart transplantation a decade ago, its success has been corroborated in numerous reports and the practice has been widely adopted. This review… 
ABO‐incompatible organ transplantation
The delay in the development of natural antibodies to ABO antigens in infants provides an ‘immunological window’ that allows for successful ABO‐incompatible transplants in this age group and allows for a unique mechanism long‐term tolerance to the graft in infants.
Strategies to overcome the ABO barrier in kidney transplantation
A continuous improvement in desensitization strategies, with the aim of minimizing the immunosuppressive burden, might pave the way to clinical outcomes that are comparable to those achieved in ABO-compatible transplantation.
Successful Pediatric ABO-Incompatible Kidney Transplantation without Pretransplant Plasmapheresis: Report of a Case
Application of different pretransplant strategies for antibody depletion in younger ABO-incompatible transplant recipients is appropriate because of differences in immunologic responses of infants and younger children.
Intraoperative anti-A/B immunoadsorption is associated with significantly reduced blood product utilization with similar outcomes in pediatric ABO-incompatible heart transplantation
  • R. Issitt, J. Booth, M. Fenton
  • Medicine
    The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
  • 2021
Neonatal heart transplantation.
The history, current indications, techniques and outcomes of heart transplantation in this immunologically-privileged subset of patients are highlighted.
The Great Ormond Street Hospital immunoadsorption method for ABO-incompatible heart transplantation: a practical technique
The practical details required to perform an intraoperative immunoadsorption technique which minimises the exposure to blood products by specifically targeting anti-A/B isohaemagglutinins in children undergoing ABO-incompatible heart transplantation are outlined.
The immune system in infants: Relevance to xenotransplantation
The factors in the infant immune system that would be advantageous in the success of cardiac xenotransplantation in this age‐group are summarized.
Immunobiology of Transplantation
This chapter reviews the basic immunologic concepts, factors, and mechanisms that contribute to transplant rejection and regulation of alloimmune responses and key transplantation antigens that can elicit an immune response against the graft are reviewed.
Dendritic Cell-Based Approaches for Therapeutic Immune Regulation in Solid-Organ Transplantation
  • G. Vassalli
  • Biology, Medicine
    Journal of transplantation
  • 2013
Two clinical trials in type-1 diabetes and rheumatoid arthritis have been carried out, and other trials, including one trial in kidney transplantation, are in progress or are imminent, suggesting that injected immunosuppressive DCs may inhibit allograft rejection, not by themselves, but through conventional DCs of the host.


ABO-mismatched heart transplantation may be undertaken safely and without any short-term adverse consequences in infants and young children in whom isohemagglutinin production is not yet established.
ABO-incompatible heart transplantation in infants.
ABO-incompatible heart transplantation can be performed safely during infancy before the onset of isohemagglutinin production and contributes to a marked reduction in mortality among infants on the waiting list.
Does ABO-incompatible and ABO-compatible neonatal heart transplant have equivalent survival?
It is concluded that ABO-I transplantation is comparable to A BO-C transplantation, several retrospective papers concluding there is no difference in mortality, and the BET conclusions should not be applied to the pediatric group as a broad age classification.
And justice for all: consideration of ABO compatibility in allocation of hearts for infant transplantation.
Pediatricians have long argued that children are not little adults, and it seems intuitive that clinical practices and regulations should follow appropriately from this paradigm. One can find no
Multicenter Experience of ABO‐Incompatible Pediatric Cardiac Transplantation
  • S. Roche, M. Burch, A. Hasan
  • Medicine
    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • 2008
It is concluded it is possible for other centers to replicate the excellent results achieved in Toronto and that ABO‐incompatible transplantation may be performed successfully in some patients beyond infancy with established isohemagglutinin production providing preoperative antibody removing strategies are used.
Successful ABO‐incompatible heart transplantation in two infants
ABO‐incompatible cardiac transplantation shows good short‐term results in young infants and appears to be a safe procedure to reduce mortality on the waiting list.
ABO-incompatible heart transplantation in infants: analysis of the united network for organ sharing database.
ABO-incompatible heart transplantation: crossing the immunological barrier.
First clinical experience of heart transplantation on a 2-month-old-infant, diagnosed with intracardiac tumour, in which the donor was a 19-day-old newborn of blood group A, safely performed with no reports of hyperacute rejection.
Equivalent Outcomes for Pediatric Heart Transplantation Recipients: ABO‐Blood Group Incompatible versus ABO‐Compatible
A nonrandomized comparison of clinical outcomes over 10 years of the largest cohort of ABO‐incompatible recipients shows there is no clinical justification for withholding this lifesaving strategy from all infants listed for heart transplantation.