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Right arrow Transplantation - heart

Ann Thorac Surg 2006;81:1105-1107
© 2006 The Society of Thoracic Surgeons

Case report

Exchange Transfusion During Extra Corporeal Membrane Oxygenation Used as a Bridge to ABO-Mismatch Cardiac Transplantation

Phil Botha, MRCS a , * , Asif Hasan, FRCS a , Simon Haynes, FRCA b , Jane Cassidy, FRCA b , Joe Roe, FRCA b , John Wallis, FRCPath c , Jon Smith, FRCA b

a Department of Cardiothoracic Surgery and Transplantation, Freeman Hospital, High Heaton, Newcastle upon Tyne, United Kingdom
b Department of Paediatric Intensive Care, Freeman Hospital, High Heaton, Newcastle upon Tyne, United Kingdom
c Department of Haematology, Freeman Hospital, High Heaton, Newcastle upon Tyne, United Kingdom

Accepted for publication January 20, 2005.

* Address correspondence to Dr Botha, c/o Ward 27A, Freeman Hospital, Newcastle upon Tyne, NE7 7DN United Kingdom (Email: phil.botha{at}nuth.northy.nhs.uk).

We report a case in which exchange transfusion was performed directly from the extracorporeal membrane oxygenation circuit in a child being bridged to cardiac transplantation. This allowed preparation for ABO-mismatched heart transplant in a child dependent on extracorporeal support, awaiting a suitable ABO-matched donor. Exchange transfusion or plasmapheresis in this setting would normally be performed on cardiopulmonary bypass to allow exsanguinations under hypothermia immediately pre-transplant. This allows little time for depletion of isohemagglutinins, occasionally leading to prolonged bypass times. We believe our method to be a safe alternative, allowing ample time for immunological preparation for ABO-incompatible transplant.




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Y. Alic, E. A. Akpek, A. Donmez, S. Ozkan, G. Y. Perfusionist, and S. Aslamaci
ABO-Incompatible Blood Transfusion and Invasive Therapeutic Approaches During Pediatric Cardiopulmonary Bypass
Anesth. Analg., October 1, 2008; 107(4): 1185 - 1187.
[Abstract] [Full Text] [PDF]


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