ABO-incompatible lung transplantation

ABO-incompatible lung transplantation has been described in four published cases, with two early deaths and two good long-term outcomes. Between 1992 and 2003, 41 additional cases have been reported to the US Scientific Registry of Transplant Recipients (SRTR). In these cases, only five early deaths (two directly ascribable to primary graft failure) have occurred, an overall incidence (12%) not significantly different than that observed for lung transplants between blood-type compatible individuals. This retrospective registry data suggest that the ABO barrier can be transgressed for the lung. Theoretical and experimental considerations relevant to transplantation in the context of preformed or induced anti-graft antibody are reviewed.