Successful management of a B-type cardiac allograft into an O-type man with 3 1/2-year clinical follow-up

Paul Mohacsi*, Robert Rieben, Gisli Sigurdsson, Hansueli Tschanz, Thomas Schaffner, Urs E. Nydegger, Thierry Carrel

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background. In May 1997, a 19-year-old male patient of histo-blood group type O suffering from congenital end-stage heart failure accidentally received a cardiac allograft of type B and is still alive in fair condition. Methods. In addition to conventional immunosuppressive therapy, plasma exchange (PEX), extracorporeal immunoabsorption (EIA), intravenous immunoglobulins (IVIG), and C1 inhibitor were used. Results. Such treatment successfully reduced both IgM and IgG anti-B levels and complement hyperactivity and allowed to reach the state of accommodation without obvious signs of rejection. The patient has been surviving for 42 months; retransplantation with an O-type heart remained unnecessary. Conclusion. Humoral rejection has been avoided in this patient, with PEX, EIA, IVIG, and C1 inhibitor substantially contributing to this success. With future availability of such combined therapies, preferably before transplantation, vascular rejection events caused by preformed antibodies and complement (ABO mismatch or anti-HLA) could be prevented or treated.

Original languageEnglish
Pages (from-to)1328-1330
Number of pages3
JournalTransplantation
Volume72
Issue number7
DOIs
Publication statusPublished - 15 Oct 2001

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