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ORIGINAL RESEARCH article

Front. Transplant.
Sec. Thoracic Transplantation
Volume 3 - 2024 | doi: 10.3389/frtra.2024.1452617
This article is part of the Research Topic Editors' Showcase: Thoracic Transplantation View all 5 articles

Single center experience with ABO-incompatible and ABO-compatible pediatric heart transplantation

Provisionally accepted
Laura Lily Rosenthal Laura Lily Rosenthal 1,2*Tabea Katharina Spikermann Tabea Katharina Spikermann 3Sahra Maria Ulrich Sahra Maria Ulrich 4Robert Dalla Pozza Robert Dalla Pozza 4Heinrich Netz Heinrich Netz 4Nikolaus Haas Nikolaus Haas 4Michael Schmoeckel Michael Schmoeckel 5Jürgen Hörer Jürgen Hörer 1,2,6Christian Hagl Christian Hagl 5,7René Schramm René Schramm 3,8Sebastian Michel Sebastian Michel 1,2Carola Grinninger Carola Grinninger 5
  • 1 Division for Pediatric and Congenital Heart Surgery, Munich, Bavaria, Germany
  • 2 European Pediatric Heart Center, LMU Munich University Hospital, Munich, Bavaria, Germany
  • 3 LMU Munich University Hospital, Munich, Germany
  • 4 Cardiology Intensive Care Unit, Department of Critical and Rehabilitative Cardiology, Monzino Cardiology Center (IRCCS), Milan, Lombardy, Italy
  • 5 Department of Heart Surgery, Munich, Bavaria, Germany
  • 6 Department of Congenital Heart Defect Surgery and Paediatric Cardiac Surgery, German Heart Centre Munich, Technical University Munich, Munich, Bavaria, Germany
  • 7 German Center for Cardiovascular Research (DZHK), Berlin, Germany
  • 8 Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany

The final, formatted version of the article will be published soon.

    Introduction The aim of this study was to analyze the results after pediatric heart transplantation (pHTx) at our single center differentiating between ABO-incompatible (ABOi) and -compatible (ABOc) procedures. Methods and patients We retrospectively analyzed outcomes of ABO-incompatible HTx procedures performed at our center and compared the data to ABO-compatible HTx of the same era. Eighteen children (< 17 months) underwent pediatric HTx and seven of them underwent ABO-incompatible HTx between 2003 and 2015. Results Mechanical circulatory support as bridge to transplant was necessary in 3/7 patients before ABO-incompatible HTx and in 3/11 patients before ABO-compatible HTx. Mean waiting time on the list was 36±30 days for ABO-incompatible HTx and 86±65 days for ABO-compatible HTx. The 5-years re-transplant free survival was 86% following ABO-incompatible and 91% after ABO-compatible. In the cohort undergoing ABO-incompatible HTx, 2 patients showed an acute cellular rejection, while early graft failure was not observed. In the cohort undergoing ABO-compatible HTx, acute cellular rejection was observed in 9/11 patients, with early graft failure occurring in nine and CVP in two. A total of ten children were listed for ABO-incompatible HTx after 2015; however, all ten underwent an ABO-compatible transplantation. Discussion This study adds much needed information to the literature on ABOi-HTx by showing with a retrospective single center analysis that it is safe and leads to shorter waiting times. We conclude that strategies for ABOi-HTx should be elaborated further, potentially allowing more timely transplantation and thereby preventing waiting list complications such as the need for mechanical circulatory support and even death.

    Keywords: Congenital heart failure, ABO-compatible HTx, ABO-incompatible HTx, Cardiomyopathy in small children. Norwood failure, Congenital heart defect (CHD)

    Received: 21 Jun 2024; Accepted: 23 Sep 2024.

    Copyright: © 2024 Rosenthal, Spikermann, Ulrich, Dalla Pozza, Netz, Haas, Schmoeckel, Hörer, Hagl, Schramm, Michel and Grinninger. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Laura Lily Rosenthal, Division for Pediatric and Congenital Heart Surgery, Munich, Bavaria, Germany

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