scholarly journals The Great Ormond Street Hospital immunoadsorption method for ABO-incompatible heart transplantation: a practical technique

Perfusion ◽  
2020 ◽  
Vol 36 (1) ◽  
pp. 34-37
Author(s):  
Richard Issitt ◽  
Richard Crook ◽  
Michael Shaw ◽  
Alex Robertson
Keyword(s):  
Adverse Effects ◽  
Heart Transplantation ◽  
Plasma Exchange ◽  
Heart Transplant ◽  
Hyperacute Rejection ◽  
Blood Products ◽  
Street Hospital ◽  
Great Ormond Street Hospital ◽  
Circulating Volume ◽  
Exchange Technique

Traditionally, ABO-incompatible heart transplantation was accomplished using a plasma exchange technique to remove recipient plasma containing donor-incompatible anti-A/B isohaemagglutinins. However, this technique exposed patients to large volumes of allogeneic blood and blood products (up to three times the patient’s circulating volume). In 2018, we published the first reported case of an ABO-incompatible heart transplant using an intraoperative immunoadsorption technique which minimises the exposure to blood products by specifically targeting anti-A/B isohaemagglutinins. We have subsequently used this technique in all children undergoing ABO-incompatible heart transplantation and become convinced of its efficacy in this population while observing no adverse effects. This article outlines the practical details required to perform the technique in order to avoid hyperacute rejection.

scholarly journals A combined approach to treat heparin-induced thrombocytopaenia before heart transplant

2020 ◽  
Vol 31 (6) ◽  
pp. 881-883 ◽  
Author(s):  
Elena Sandoval ◽  
Miquel Lozano ◽  
Daniel Pereda ◽  
Eduard Quintana ◽  
Joan Cid ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Plasma Exchange ◽  
Intravenous Immunoglobulin ◽  
Heart Transplant ◽  
Mechanical Circulatory Support ◽  
Treatment Options ◽  
Circulatory Support ◽  
Combined Approach ◽  
Plasma Exchange Therapy ◽  
Combined Use

Abstract Heparin-induced thrombocytopaenia (HIT) complicates the management of patients in need for mechanical circulatory support awaiting heart transplantation. The limited available treatment options are fraught with complications and limitations in their applicability. We report on the combined use of therapeutic plasma exchange therapy and intravenous immunoglobulin, used in 3 consecutive heparin-induced thrombocytopaenia-positive patients on temporary mechanical circulatory support awaiting urgent heart transplant. This combined approach allowed us to use heparin safely.

2 GOSHPODS: paediatric educational podcast series from great ormond street hospital

2021 ◽  
Author(s):  
Sara Cooke ◽  
Sara Warraich ◽  
Jeroen Poisson ◽  
Simon Blackburn ◽  
Abhimanu Lall
Keyword(s):  
Street Hospital ◽  
Great Ormond Street Hospital

371: Mycophenolic Trough Levels and Adverse Effects in Heart Transplant Population

2009 ◽  
Vol 28 (2) ◽  
pp. S194
Author(s):  
L.S.L. Ting ◽  
J. Haymond ◽  
N. Partovi ◽  
C. Imai ◽  
A.P. Ignaszewski ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Heart Transplant ◽  
Trough Levels

scholarly journals A 6-YEAR EXPERIENCE OF HEART TRANSPLANTATION IN FEDERAL ALMAZOV NORTH-WEST MEDICAL RESEARCH CENTRE

2017 ◽  
Vol 18 (4) ◽  
pp. 33-42 ◽  
Author(s):  
E. V. Shlyakhto ◽  
M. L. Gordeev ◽  
M. A. Karpenko ◽  
G. V. Nikolaev ◽  
A. S. Gnevashev ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Medical Research ◽  
Heart Transplant ◽  
Graft Loss ◽  
Research Centre ◽  
Tricuspid Valve Repair ◽  
North West ◽  
Transplant Candidates ◽  
Batista Procedure ◽  
High Level

Aim. To estimate the results of 6-year experience of heart transplantation (HT) in Federal Almazov North-West Medical Research Centre. Methods. From 2010 to 2015 we have performed 65 HT. Mean age was 44.3 ± 14 years old (from 10 to 64 years old). We used biventricular assist device (BIVAD, Berlin Heart Excor) support in 7 heart transplant candidates before HT. 19 patients (29%) received thymoglobulin, whereas 46 patients (71%) had basiliximab to induce immunosuppression.Results.Extracorporeal membrane oxygenation machines were implanted in 5 patients (7.7%) after HT due to acute right ventricular failure. Suture annuloplasty (the Batista procedure) for tricuspid valve repair was carried out in 3 cases (4.6%). Venovenous hemodiafi ltration was used in 11 patients (16.9%). A total of 598 endomyocardial biopsies (EMB) were performed after HT. Evidence of cellular rejection (R1 and R2) was presented in 286 biopsies (48%). The 30-day in-hospital mortality rate was 3.1%. The 6-month survival rate after HT was 92%, 1-year – 91% and overall survival for the 6-year period of observation – 89.2%. Maximum observation period was 71 months.Conclusions.The 6-year experience of HT in our Center has shown a high level of survival. BIVAD Excor support can be effectively used as a «bridge» to HT. Prevention of graft loss due to acute rejection in heart transplant recipients can be achieved only through regular EMB monitoring. The rate of viral infection increased in 2 months after HT.

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