Abstract
Heart transplantation with ABO blood type-incompatible donors has historically been contraindicated because of the high risk of an immediate hyperacute humoral graft rejection. The immature neonatal immune system presents an immunologic window that allows for breaching the ABO barrier before the natural development of anti-ABO antibodies. Information from a small series of neonates has demonstrated similar survival rates and posttransplant outcomes compared to ABO-compatible transplantations. In the posttransplant period, particular attention is placed on the surveillance of graft-specific antibody production and monitoring for immunologic signs and symptoms of early graft vasculopathy. This article presents a case study of a neonate with congenital heart disease who underwent one of the first successful ABO-incompatible heart transplantations in the United States.
MeSH terms
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ABO Blood-Group System*
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Aftercare / methods
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Blood Group Incompatibility* / complications
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Blood Group Incompatibility* / diagnosis
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Blood Group Incompatibility* / therapy
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Blood Grouping and Crossmatching / methods
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Donor Selection / methods*
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Graft Rejection / etiology
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Graft Rejection / immunology
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Graft Rejection / prevention & control
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Graft Survival
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Heart Transplantation / adverse effects
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Heart Transplantation / immunology*
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Heart Transplantation / statistics & numerical data
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Humans
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Hypoplastic Left Heart Syndrome / complications
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Hypoplastic Left Heart Syndrome / immunology
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Hypoplastic Left Heart Syndrome / surgery
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Immunosuppressive Agents / therapeutic use
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Infant, Newborn / immunology
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Male
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Postoperative Care / methods
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Preoperative Care / methods
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Risk Factors
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Transplantation Immunology
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Treatment Outcome
Substances
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ABO Blood-Group System
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Immunosuppressive Agents