Use of an allograft patch in repair of hypoplastic left heart syndrome may complicate future transplantation

Abstract

Allograft tissue used in the repair of HLHS is associated with profound donor specific immunologic sensitization in the majority of recipients and may complicate or jeopardize future transplantation. Methods to reduce the immunogenicity of cryopreserved allograft tissue used for arch reconstruction requires further investigation.

Síndrome da hipoplasia do coração esquerdo: a influência da estratégia cirúrgica nos resultados

“…This was a simple solution that resulted in a favorable morphology for the neoaorta and low incidence of postoperative coarctation. One of the most frequently employed techniques for aortic arch reconstruction includes the use of pulmonary homografts, but they are expensive, difficult to obtain, and immunologic sensitization may lead to further problems if heart transplantation is required 12,17,18 . Direct aortic anastomosis is technically more complex and cannot always be performed, although no difference is observed in relation to homologous grafts as for the need for aortic arch reintervention [19][20][21][22] .…”

Transplantation and Mechanical Circulatory Support in Congenital Heart Disease

“…[108][109][110] In these patients, a high PRA (>10%) was associated with poorer outcomes after transplantation. 108 Exposure to allograft tissue during a Norwood procedure was associated with long-term sensitization in 56% of patients.…”

Síndrome do coração esquerdo hipoplásico: estratégia cirúrgica e comparação de resultados com técnicas de Norwood x Sano

“…Moreover, these grafts may cause future problems if heart transplantation is necessary [16,23]. The direct anastomosis of the aorta is technically more complex and not always feasible, even though no significant differences have been reported between this technique and homologous grafts in respect to the necessity of reinterventions of the aortic arch [5,6,8].…”

“…Homologous pulmonary grafts are the most commonly used materials for reconstruction however they induce the formation of antibodies [8] and are very expensive.…”