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Network Eases Rule on Transplants

November 15, 2001

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DENVER (AP) _ Inspired by the death of a 6-week-old girl, the nation’s transplant network voted Thursday to ease its rules on giving new hearts to infants.

The new policy by the United Network of Organ Sharing policy will let babies under 1 year old get hearts that don’t match their blood types.

The change, which will be implemented as soon as possible, came after a Colorado baby named Arionna Harris died at 6 weeks old while awaiting a heart.

``This is her gift back to society,″ said Dr. Mark Boucek, director of the pediatric heart transplant program at Children’s Hospital in Denver, who campaigned for the change.

The Richmond, Va.-based organ network maintains the nation’s waiting list for organ transplants.

Under the policy, donor hearts will be offered first to recipients with compatible blood types and then to those younger than 12 months with other blood types, network spokeswoman Anne Paschke said.

Doctors say there is evidence that infants can tolerate hearts from incompatible donors. Critics have questioned whether the risks are too great and whether the policy change would deprive babies with matching blood of heart donations.

Dr. Frederick Grover, chairman of the organ network’s thoracic committee, said the proposal is crafted so there will not be a disadvantage to babies listed for a specific blood type.

``If anything, it will allow more organs to be utilized and get to the recipient centers so there is a shorter waiting list. For the children who need hearts, the clock is ticking,″ said Grover, head of cardiothoracic surgery at the University of Colorado Health Sciences Center.

About one in every 5,000 newborns suffers from congenital heart disease and can be a candidate for a heart transplant. Type O recipients are compatible only with type O donors, while recipients with A, B and AB blood can be matched with other types.

In a March study in the New England Journal of Medicine, Canadian doctors said they transplanted hearts of incompatible blood type into 10 children. The recipients, as old as 14 months, were almost all of type O blood. In most, immune systems did not yet produce antibodies against incompatible blood types.

Dr. Lori West and her colleagues at the Hospital for Sick Children in Toronto reported a survival rate of 80 percent among such patients, as good as the rate with compatible donors.

Arionna, daughter of 19-year-old Tiffany Ray of Rockvale, died Sept. 23 at Children’s Hospital. She had been on the waiting list for a heart because her left ventricle wasn’t developing properly.

Before her birth, doctors considered giving Arionna a heart with any blood type because a match couldn’t be found for her type O blood.

Boucek said there is evidence that 40 to 80 heart donors are not matched to infant recipients annually in the United States. He said blood grouping may be a large part of the reason.

Ray said she wants to raise awareness about organ donation and help other parents. She also is pushing for the policy change at UNOS.

``I wanted it to be done so other parents don’t have to go through what we’re going through,″ Ray said. ``I feel that Arionna would have made it. She was a really strong-willed kid.″


On the Net:

United Network for Organ Sharing: http://www.unos.org

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