Trasplante cardiaco con incompatibilidad de grupo

Abstract

IntroductionSince pioneer work in Canada, non-compatible paediatric heart transplantation is gaining worldwide acceptance. Low titres of anti-A and anti-B isohaemagglutinins under 12-14 months of age warrant this strategy. Outstanding short and midterm results encourage joining new programmes. We present our preliminary scores. MethodsWe collected retrospective data between September 2017 and August 2021. Thirty-one paediatric (<18 years) heart transplants were performed. Sixteen patients met the inclusion criteria: age below 12 months and isohaemagglutinin titres<1/8. An intraoperative blood-exchange chart was made, when required. Waiting-list days, rejection episodes and death rate in the first year are defined as endpoints, comparing ABO compatible and non-compatible transplants. ResultsSix out of 16 recipients received a non-compatible graft. Waiting-list median was shorter in the non-compatible group (42.3 vs. 72.3 days) with P=.263. No blood-exchange was needed in any recipient. One patient in each group presented with rejection episodes. Two patients (2/10) in the compatible and one child (1/6) in the non-compatible group died in the follow-up. ConclusionsAbove one third (6/16) of included recipients received a non-compatible graft. None of them were blood exchanged during transplantation. Waiting list was shorter in this group. No differences in rejection episodes nor death rate in the first year were recorded between compatible and non-compatible groups.