Antibodies to human leukocyte antigens and their association with blood product exposures in pediatric patients undergoing cardiac transplantation

Abstract

Background and Aims: Previous blood product exposures may result in the development of antibodies to human leukocyte antigens (HLA). Pediatric heart transplant recipients who have these antibodies experience increased morbidity and mortality after transplantation. In this study, our aims were to confirm the association of previous allogeneic blood product exposures with the formation of anti-HLA antibodies, determine which blood components pose the greatest risk of developing antibodies, and assess differences in outcomes after transplantation between patients who had anti-HLA antibodies and those who did not. Methods:This retrospective investigation included all children who underwent car-

“Take it or leave it”: Analysis of pediatric heart offers for transplantation in Switzerland

“…Especially in recipients with previous blood transfusions, increased HLA incompatibility might be expected. 18 Due to growth during childhood, the issue of donor-recipient size match is very important in pediatric heart transplantation. In the Swiss allocation process, the sizes of the hearts of donor and recipient are estimated by body weight and evaluated with the donor-recipient weight ratio.…”

“…However, this assumption does not include HLA matching. Especially in recipients with previous blood transfusions, increased HLA incompatibility might be expected 18 …”

Could we reduce the incidence of immune sensitization prior to heart transplant by reducing exposure to allogeneic blood transfusion?

“…

Could we reduce the incidence of immune sensitization prior to heart transplant by reducing exposure to allogeneic blood transfusion?In this issue of Pediatric Anesthesia, Cruz-Beltran and colleagues report the results of a single-center retrospective study evaluating the association between HLA antibodies and prior exposure to allogeneic blood products in pediatric patients undergoing heart transplantation. 1

…”

“…The primary objective of the study published by Cruz-Beltran et al was to determine the relationship between previous exposure to allogeneic blood products and the presence of anti-HLA antibodies at the time of transplantation. 1 Sixty-four children underwent orthotopic heart transplantation between January 1, 2015 and December 31, 2018. A total of 29 patients (45%) were reported to be HLA ab+ at the time of heart transplantation.…”