@article {4431,
	title = {Anti-B-mediated rejection of an ABO-incompatible cardiac allograft despite aggressive plasma exchange transfusion.},
	journal = {Transplantation proceedings//Transplant Proc},
	volume = {19},
	year = {1987},
	month = {1987},
	pages = {4601 - 4},
	publisher = {Pikul,F J. Department of Pathology, Washington University School of Medicine, St Louis, MO.},
	address = {UNITED STATES},
	abstract = {A group A recipient received a group B cardiac allograft. Aggressive plasma exchange with replacement by group AB FFP initially reduced the recipient{\textquoteright}s anti-B titer to a low level. Once a secondary anti-B response was mounted, plasma exchange was ineffective and IgM and IgG anti-B titers rose to high levels. Associated with the increased anti-B titers, cardiac function deteriorated and on day 13 the group B heart was replaced by a group A allograft. The compatible allograft functioned well initially but was eventually rejected, and the patient died 51 days after the initial transplantation. Histologic examination of the first allograft revealed a delayed form of typical antibody-mediated rejection with destruction of the microvasculature associated with antibody deposition and acute inflammation. By contrast, the histopathology of the second compatible allograft was typical of cell-mediated allograft rejection. Extracts of myocardium from the incompatible heart contained IgM and IgG anti-B, while no anti-B alloantibody was demonstrable in the extracts of the ABO-compatible allograft and a control heart. The utility of plasma exchange with group AB FFP replacement in such a circumstance requires further study.},
	keywords = {*ABO Blood-Group System/im [Immunology], *Blood Group Incompatibility/im [Immunology], *Heart Transplantation, Blood Group Incompatibility/th [Therapy], Humans, Immunoglobulin G/an [Analysis], Immunoglobulin M/an [Analysis], Isoantibodies/an [Analysis], Middle Aged, Plasma Exchange},
	isbn = {0041-1345},
	author = {Pikul, F J and Bolman, R M and Saffitz, J E and Chaplin, H}
}
