Toggle Main Menu Toggle Search

Open Access padlockePrints

The Newcastle University research output collection, currently available on ePrints, will shortly be moving to a new open repository platform, Figshare. To prepare for the data migration we have paused adding new content to ePrints, and will resume once the new repository is launched. During this time you will continue to have access to ePrints (but no new content will appear). We will share updates here when available.

ABO-incompatible cardiac transplantation in pediatric patients with high isohemagglutinin titers

Lookup NU author(s): Professor Andrew GenneryORCiD, Dr Jonathan Wallis

Downloads

Full text for this publication is not currently held within this repository. Alternative links are provided below where available.

Abstract

BACKGROUND: ABO-incompatible (ABOi) cardiac transplantation is now used widely in infants with isohemagglutinin titers < 1:4, but there is increasing evidence that ABOi transplantation can also be used in children with significantly higher titers. We reviewed our high-titer ABOi transplants and report our results here.METHODS: Patients who underwent ABOi cardiac transplantation from 2000 to 2013 with pre-existing isohemagglutinin titers of >= 1:16 were identified from departmental databases. Outcomes were reviewed using medical and laboratory records.RESULTS: Thirty patients underwent ABOi cardiac transplantation between 2000 and 2013. Twelve (40%) had pre-transplant isohemagglutinin titers of >= 1:16 and were included for further study. Median age was 14.9 (range 9.8 to 107.3) months and median weight was 9.6 (range 7.6 to 25) kg. Five (42%) were male. Pre-transplant diagnosis was cardiomyopathy in 8 of 12 (67%) and congenital heart disease in 4 of 12 (33%). Highest pre-transplant isohemagglutinin titer was 1:256 in 2 patients. Four patients (33%) had early antibody-mediated rejection (AMR), all within 15 days post-transplant. Management included use of rituximab, bortezomib, immunoadsorption and eculizumab. Three patients died but no deaths were associated with high isohemagglutinin titers.CONCLUSIONS: ABOi cardiac transplantation in patients with isohemagglutinin titers >= 1:16 is possible. AMR may occur early and immunoadsorption has proven effective at decreasing antibody titers. (C) 2015 International Society for Heart and Lung Transplantation. All rights reserved.

Publication metadata

Author(s): Irving CA, Gennery AR, Carter V, Wallis JP, Hasan A, Griselli M, Kirk R

Publication type: Article

Publication status: Published

Journal: Journal of Heart and Lung Transplantation

Year: 2015

Volume: 34

Issue: 8

Pages: 1095-1102

Print publication date: 01/08/2015

Online publication date: 26/03/2015

Acceptance date: 01/01/1900

ISSN (print): 1053-2498

ISSN (electronic): 1557-3117

Publisher: Elsevier

URL: http://dx.doi.org/10.1016/j.healun.2015.03.013

DOI: 10.1016/j.healun.2015.03.013

Altmetrics

Altmetrics provided by Altmetric

Share