J Chest Surg.  2024 Mar;57(2):217-219. 10.5090/jcs.23.088.

Successful Heart Transplantation Despite Rhesus Blood Type Mismatch: A Case Report

• Kim JH
• Shin YR

• KMID: 2553686
• DOI: http://doi.org/10.5090/jcs.23.088

Abstract

Matching for the rhesus (Rh) blood group is currently not taken into account in the organ allocation system. However, in Rh-mismatched transplantation, the primary concern is the potential for RhD-negative recipients to develop sensitization and produce anti-D antibodies if they receive a transfusion of RhD-positive blood. It is estimated that over 80% of RhD-negative recipients may experience Rh allosensitization when exposed to RhD-positive blood, although this occurrence is less common in recipients of solid organs. In theory, RhD-negative recipients who receive organs from RhD-positive donors are at risk of alloimmunization and the production of anti-D antibodies, which could complicate future blood product transfusions. However, our understanding of the impact of donor-recipient Rh mismatch on transplant outcomes, particularly in heart transplantation, is limited. We report a case of successful Rh-mismatched heart transplantation, which was effectively managed through the use of preoperative RhD immunoglobulin and plasmapheresis.

Keyword

Rh blood group; Plasmapheresis; Blood type incompatibility; Case reports