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For Immediate Release

"Mismatched" Heart Transplants at Children's Hospital Save Youngest of Babies Who Might Otherwise Have No Donor

Increasing awareness of organ donor shortage issues is focus of Donate Life Month in April

Transplant leaders at Children's Hospital of Pittsburgh of UPMC are increasingly turning to an innovative procedure to make transplant surgery an option for young children with life-threatening heart failure.

Typically anyone receiving an organ transplant must receive an organ from a donor of the same or compatible blood type in order to avoid severe rejection. However, infants and children up to about age 2 can receive hearts from donors of incompatible blood types because they have not yet developed certain antibodies that would lead to acute rejection, according to Steven A. Webber, MBChB, chief of the Division of Pediatric Cardiology  at Children's.

Such heart transplants are called ABO incompatible transplants and Children's Hillman Center for Pediatric Transplantation has performed five in the last year under the leadership of Dr. Webber and Victor O. Morell, MD, chief of Cardiothoracic Surgery at Children's.

"About one in five children waiting for a heart transplant will die before an organ becomes available because of a scarcity of heart donors," said Dr. Webber, professor of Pediatrics at the University of Pittsburgh School of Medicine. "Incompatible heart transplants open the donor pool considerably and are an emerging option for very young children who might otherwise die waiting for a heart."

Children's transplant physicians and surgeons are exploring such cutting-edge approaches to improve outcomes from transplant and reduce the mortality of pediatric patients waiting for a transplant. The national organ donor shortage – more than 95,000 people are waiting for a transplant, according to the United Network for Organ Sharing (UNOS)  – is the focus of Donate Life Month in April. Approximately 18 people nationwide, including 6 children, die each day waiting for a transplant. Children's is celebrating Organ Donor Awareness Week the week of April 16 to promote awareness about organ and tissue donation.

ABO incompatible heart transplants were pioneered a decade ago by doctors at the Hospital for Sick Children in Toronto. Only a few dozen such transplants ever have been performed in children worldwide.

Since 2002, UNOS guidelines have allowed ABO incompatible heart transplants in infants up to 1 year old and the organization now is expanding those guidelines to age 2 for selected patients, Dr. Webber said. At Children's, which is a leading heart transplant center, surgeons are preparing to perform ABO incompatible heart transplants more and more frequently as a way of offering heart transplantation to critically ill heart patients when a donor of the same type is not immediately available. Only a handful of centers across the country perform this procedure.

"For a young patient in heart failure who will die without a transplant, there are very limited options, including ventricular assist devices and extracorporeal membrane oxygenation, which can only be used for a short amount of time," said Dr. Morell, an associate professor of Surgery at the University of Pittsburgh School of Medicine. "Based on our first five cases and the cases done at a handful of other centers, ABO incompatible transplants are proving to be a successful, long-term option."

Learn more about Children's Hillman Center for Pediatric Transplantation.


Marc Lukasiak, 412-692-7919 or 412-692-5016,
Melanie Finnigan, 412-692-5502 or 412-692-5016,

Last Update
September 20, 2012
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Last Update
September 20, 2012