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ABO-incompatible pediatric heart transplantation - Past, present, and future

This video is a collaboration between Transplant Families and the Pediatric Heart Transplant Society. Join us to learn more about how children needing transplants may soon have more opportunities with expanded ABOi policy changes. Presenters: Anne I. Dipchand, MD is Professor of Paediatrics at the University of Toronto and a Paediatric Cardiologist and the head of the Heart Transplant Program at the Hospital for Sick Children (SickKids), Toronto Dr. Simon Urschel is a Pediatric Cardiologist and Immunologist and Director of the Pediatric Heart Transplant program at the Stollery Children’s Hospital, Edmonton Dr. Brian Feingold is Medical Director of the Heart Failure and Transplant Programs at UPMC Children’s Hospital of Pittsburgh and a Professor of Pediatrics and Clinical and Translational Science at the University of Pittsburgh Blood types A, B, AB, and O are determined by markers on the surface of red blood cells and other cells, including cells in organ transplants. When a person receives a transplant, the donated organ typically comes from a donor with a blood type that is compatible with the recipient. This is done to prevent rejection of the organ due to an incompatible marker. However, in pediatric heart and lung transplantation, blood type incompatible transplants (called ABOi transplants) have been shown over the last 25 years to be as equally safe and effective as ABO compatible transplants in young children. The benefits of ABO incompatible heart transplantation is shorter wait list times (for blood type O candidates who usually wait the longest) and fewer donor hearts going to waste because they could not be given to a compatible blood group individual. Current OPTN policy allows patients who are put on the waiting list for heart or lung transplantation before age 2 to receive an ABOi transplant if they meet certain safety criteria. However, the growing experience with ABOi heart and lung transplantation suggests that ABOi transplant suitability can be safely expanded to other, older age groups. This has led to a policy revision proposal that seeks to broaden the availability of ABOi heart and lung transplants. In the policy revision, anyone who is placed on the heart, heart-lung, or lung transplant list prior to age 18 and who meets these safety criteria would be eligible for an ABOi transplant. By expanding access to ABOi transplants, the hope is to provide transplants more quickly to those with the greatest need, allow for repeat ABOi transplantation of individuals who previously received an ABOi transplant, and to decrease the chance that hearts and lungs are not used because of blood type issues. To find out more detailed OPTN policy details, see videos, or make public comment go to https://optn.transplant.hrsa.gov/poli... . Chapters: 00:00 Introduction 07:36 Dr. Simon Urshel - History 24:08 Dr. Anne Dipchand - Outcomes 33:40 Dr. Brian Feingold - Future and proposed policy 47:03 Questions and answers