Successful ABO incompatible heart transplantation after desensitization therapy in an older child.
ABO incompatibility
children
desensitization
heart transplantation
Journal
Pediatric transplantation
ISSN: 1399-3046
Titre abrégé: Pediatr Transplant
Pays: Denmark
ID NLM: 9802574
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
revised:
08
12
2022
received:
20
10
2022
accepted:
14
12
2022
medline:
20
4
2023
pubmed:
5
1
2023
entrez:
4
1
2023
Statut:
ppublish
Résumé
ABO-incompatible heart transplantation (HTx) has become a standard procedure for children below 2 years of age due to an immunologically immature immune system and associated low isohemagglutinin titers. We report a case of an ABO-incompatible HTx (recipient blood group O, donor blood group A) at the age of 5 years and 11 months with a fully matured immune system and previously high isohemagglutinin titers that diminished as a result of human leucocyte antigen (HLA) desensitization therapy with rituximab and immunoglobulins. The anti-A titer at the time of HTx was 1:16 with post-transplant isoagglutinin titers never exceeding 1:4 without any signs of rejection with now 3 years of post-HTx follow-up. ABO isohemagglutinin titers should be routinely assessed in children undergoing desensitization therapy since ABOi transplantation can be considered in selected cases to expand the donor pool with the option of crossing the ABO barrier to find a better-matched allograft.
Sections du résumé
BACKGROUND
ABO-incompatible heart transplantation (HTx) has become a standard procedure for children below 2 years of age due to an immunologically immature immune system and associated low isohemagglutinin titers.
METHODS
We report a case of an ABO-incompatible HTx (recipient blood group O, donor blood group A) at the age of 5 years and 11 months with a fully matured immune system and previously high isohemagglutinin titers that diminished as a result of human leucocyte antigen (HLA) desensitization therapy with rituximab and immunoglobulins.
RESULTS
The anti-A titer at the time of HTx was 1:16 with post-transplant isoagglutinin titers never exceeding 1:4 without any signs of rejection with now 3 years of post-HTx follow-up.
CONCLUSIONS
ABO isohemagglutinin titers should be routinely assessed in children undergoing desensitization therapy since ABOi transplantation can be considered in selected cases to expand the donor pool with the option of crossing the ABO barrier to find a better-matched allograft.
Substances chimiques
Hemagglutinins
0
Rituximab
4F4X42SYQ6
ABO Blood-Group System
0
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14459Informations de copyright
© 2023 The Authors. Pediatric Transplantation published by Wiley Periodicals LLC.
Références
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