Mechanical ventricular assist device as a bridge to recovery post-ABO-incompatible heart transplantation for failed Fontan circulation

作者：Seitz Stefanie^*; Buchholz Holger; Rebeyka Ivan; Ross David; West Lori; Urschel Simon

来源：Transplant International, 2014, 27(7): e54-e57.

DOI：10.1111/tri.12294

• ABO incompatibility
• allograft dysfunction
• failed Fontan circulation
• heart transplantation
• mechanical circulatory support
• protein-losing enteropathy

A girl received an ABO-incompatible heart transplantation (ABOiHTx) at the age of 3.5years for failed univentricular palliation with protein-losing enteropathy (PLE). She was born with a hypoplastic left heart syndrome and underwent multistage palliation to a Fontan circulation at 21/2years of age. After the Fontan surgery, she developed PLE, necessitating a Fontan revision, followed by a Fontan takedown and eventually HTx, which was performed with a blood group B heart into an O recipient. Right ventricular (RV) failure secondary to increased pulmonary vascular resistance (PVR) evolved immediately after HTx. A temporary right ventricular assist device (RVAD) was implanted and later switched to a pneumatic pulsatile RVAD. With the adaption of PVR on the RVAD, the PLE resolved and the RVAD was explanted. In the following 12months, she developed multiple relapses of PLE which eventually resolved after exchange of the calcineurin inhibitor.

• 出版日期2014-7