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Blood-incompatible infant heart transplants safe, may save more lives
Date:11/5/2007

35 infants (6 percent) received hearts from ABO-incompatible donors. Two ABO-compatible infants died from hyperacute rejection, while no ABO- incompatible infants died from hyperacute rejection.

ABO-incompatibility did not predict mortality. The statistical analysis was adjusted for the different size cohorts, assuring statistical significance.

Survival in both groups reached 75 percent at three years after transplantation. Infants with congenital heart disease (defects existing since birth) represent the predominant group requiring transplantation.

In the study, 71 percent of the incompatible recipients had some form of structural heart disease compared to 66 percent in the compatible group.

Cardiomyopathies, disorders of the heart muscle, represent a second condition requiring transplantation in infants.

Heart function deteriorates until the only option is transplantation. In the study, 11 percent of the incompatible recipients had cardiomyopathy versus 29 percent in the compatible group.

One key reason incompatible transplantation works in infants is the role of antibodies known as isohemagglutinins.

Until age 12 to 14 months, infants have immature immune systems with little or no production of these antibodies. That means they will not have pre-formed antibodies against the donor heart, lowering the risk of rejection.

Vricella said the most challenging transplants are in infants born with structural heart disease, congenital heart anomalies. These infants are being transplanted as a re-operation, which involves conversion of their anatomy to normal so that they can accommodate the donor heart, he said.

Vricella said that successful infant heart transplantation means an infant can go home and have a great quality of life.


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Contact: Karen Astle
karen.astle@heart.org
214-706-1392
American Heart Association
Source:Eurekalert

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