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Lessons from ABO-Incompatible Cardiac Allotransplantation in the Newborn

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Clinical Xenotransplantation

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Abstract

Successes associated with cardiac transplantation in newborn infants, especially ABO-incompatible transplantation, may offer lessons pertinent for the transplantation of organs and tissues from animals into man, that is, xenotransplantation. For example, the scarcity of hearts of suitable size and condition for transplantation in newborn infants with severe cardiac failure, which motivated the use of ABO-incompatible hearts, also motivates consideration of using hearts from animals in lieu of hearts from humans, i.e., xenotransplantation, for this purpose. Clearly, xenotransplantation could address this problem, but the various biological barriers to xenotransplantation, especially the immune barrier, may preclude application of this approach. Because several components of the immune barrier to xenotransplantation are modeled by ABO-incompatible allografts, insights drawn from the successful transplantation of ABO-incompatible hearts in newborn infants might be pertinent to the application of xenotransplantation in infants or, indeed, in all human recipients. Here, we review those insights and discuss the potential relevance for xenotransplantation.

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Abbreviations

Gal:

Galactose-α1,3-galactose

HLA:

Human leukocyte antigen

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Acknowledgment

Supported by grants from the National Institutes of Health (AI123262, AI122369, OD023138)

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  1. Departments of Surgery and Microbiology & Immunology, University of Michigan, Ann Arbor, MI, USA

    Jeffrey L. Platt & Marilia Cascalho

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  1. Jeffrey L. Platt
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  2. Marilia Cascalho
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Correspondence to Jeffrey L. Platt .

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Editors and Affiliations

  1. Xenotransplantation Program, University of Alabama at Birmingham, Birmingham, AL, USA

    David K. C. Cooper

  2. Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA

    Guerard Byrne

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Platt, J.L., Cascalho, M. (2020). Lessons from ABO-Incompatible Cardiac Allotransplantation in the Newborn. In: Cooper, D.K.C., Byrne, G. (eds) Clinical Xenotransplantation. Springer, Cham. https://doi.org/10.1007/978-3-030-49127-7_12

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