ABO-incompatible lung transplantation in an infant

Am J Transplant. 2012 Mar;12(3):779-81. doi: 10.1111/j.1600-6143.2011.03861.x. Epub 2011 Dec 7.


Waitlist mortality continues to be a limiting factor for all solid-organ transplant programs. Strategies that could improve this situation should be considered. We report the first ABO-incompatible lung transplantation in an infant. The recipient infant was ABO blood group A1 and the donor group B. The recipient was diagnosed with surfactant protein B deficiency, which is a fatal condition and lung transplantation is the only definitive therapy. At 32 days of age, a bilateral lung transplantation from a donation after cardiac death (DCD) donor was performed. Intraoperative plasma exchange was the only preparatory procedure performed. No further interventions were required as the recipient isohemagglutinins were negative before transplant and have remained negative to date. At 6 months posttransplant, the recipient is at home, thriving, with normal development. This outcome suggests that ABO-incompatible lung transplantation is feasible in infants, providing another option to offer life-saving lung transplantation in this age range.

Publication types

  • Case Reports

MeSH terms

  • ABO Blood-Group System / immunology*
  • Blood Group Incompatibility*
  • Humans
  • Infant
  • Lung Transplantation*
  • Male
  • Pulmonary Alveolar Proteinosis / congenital*
  • Pulmonary Alveolar Proteinosis / therapy
  • Pulmonary Surfactant-Associated Protein B / deficiency
  • Tissue Donors
  • Treatment Outcome


  • ABO Blood-Group System
  • Pulmonary Surfactant-Associated Protein B

Supplementary concepts

  • Congenital Deficiency of Pulmonary Surfactant Protein B