دورية أكاديمية

Intraoperative anti-A/B immunoadsorption is associated with significantly reduced blood product utilization with similar outcomes in pediatric ABO-incompatible heart transplantation

التفاصيل البيبلوغرافية
العنوان: Intraoperative anti-A/B immunoadsorption is associated with significantly reduced blood product utilization with similar outcomes in pediatric ABO-incompatible heart transplantation
المؤلفون: Issitt, R, Booth, J, Crook, R, Robertson, A, Molyneux, V, Richardson, R, Cross, N, Shaw, M, Tsang, V, Muthurangu, V, Sebire, NJ, Burch, M, Fenton, M
المصدر: The Journal of Heart and Lung Transplantation (2021) (In press).
سنة النشر: 2021
المجموعة: University College London: UCL Discovery
مصطلحات موضوعية: cardiopulmonary bypass, heart transplantation, immunoadsorption, pediatrics
الوصف: BACKGROUND: Intraoperative anti-A/B immunoadsorption (ABO-IA) was recently introduced for ABO-incompatible heart transplantation. Here we report the first case series of patients transplanted with ABO-IA, and compare outcomes with those undergoing plasma exchange facilitated ABO-incompatible heart transplantation (ABO-PE). METHODS: Data were retrospectively analysed on all ABO-incompatible heart transplants undertaken at a single centre between January 1, 2000 and June 1, 2020. Data included all routine laboratory tests, demographics and pre-operative characteristics, intraoperative details and post-operative outcomes. Primary outcome measures were volume of blood product transfusions, maximum post-transplant isohaemagglutinin titres, occurrence of rejection and graft survival. Secondary outcome measures were length of intensive care and hospital stay. Demographic and survival data were also obtained for ABO-compatible transplants during the same time period for comparison. RESULTS: Thirty-seven patients underwent ABO-incompatible heart transplantation, with 27 (73%) using ABO-PE and 10 (27%) using ABO-IA. ABO-IA patients were significantly older than ABO-PE patients (p < 0.001) and the total volume of blood products transfused during the hospital admission was significantly lower (164 [126-212] ml/kg vs 323 [268-379] ml/kg, p < 0.001). No significant differences were noted between methods in either pre or post-transplant maximum isohaemagglutinin titres, incidence of rejection, length of intensive care or total hospital stay. Survival comparison showed no significant difference between antibody reduction methods, or indeed ABO-compatible transplants (p = 0.6). CONCLUSIONS: This novel technique appears to allow a significantly older population than typical to undergo ABO-incompatible heart transplantation, as well as significantly reducing blood product utilization. Furthermore, intraoperative anti-A/B immunoadsorption does not demonstrate increased early post-transplant isohaemagglutinin accumulation or ...
نوع الوثيقة: article in journal/newspaper
وصف الملف: text
اللغة: English
العلاقة: https://discovery.ucl.ac.uk/id/eprint/10130842/1/1-s2.0-S1053249821023251-main.pdfTest; https://discovery.ucl.ac.uk/id/eprint/10130842Test/
الإتاحة: https://discovery.ucl.ac.uk/id/eprint/10130842/1/1-s2.0-S1053249821023251-main.pdfTest
https://discovery.ucl.ac.uk/id/eprint/10130842Test/
حقوق: open
رقم الانضمام: edsbas.5650EB4E
قاعدة البيانات: BASE