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Intraoperative anti-A/B immunoadsorption (ABO-IA) was introduced for ABO-incompatible heart transplantation at Great Ormond Street Hospital for Children (GOSH) in 2015. Since then several patients have undergone ABOi transplantation at GOSH and at other centres around Europe using the technique. Here we discuss the ex-vivo model used to create the methodology, as well as the first case series of patients transplanted with ABO-IA undertaken at GOSH, comparing outcomes with those undergoing plasma exchange facilitated ABO-incompatible heart transplantation (ABO-PE). Finally, a case study will be used to illustrate how intraoperative anti-A/B immunoadsorption is pushing the boundaries of who can be treated with ABOi transplantation.
|Anne Dipchand, Canada|