Glutaraldehyde treatment of allograft tissue decreases allosensitization after the Norwood procedure

Abstract

Intraoperative glutaraldehyde treatment of allograft tissue used in hypoplastic left heart syndrome repair prevents the profound immunologic sensitization that occurs in the majority of infants undergoing surgical palliation. In patients requiring subsequent heart transplantation, this decreases the risk of antibody-mediated rejection and increases the likelihood of finding a suitable donor, thus improving access to transplantation.

Outcome of Right Ventricle to Pulmonary Artery Conduit for Biventricular Repair

“…Additionally, the immune reaction to the homograft or xenograft materials could adversely affect the future heart transplantation with elevated panel reactive antibody [17]. There were several successful attempts to decrease the immune reaction to the homograft by correction of blood group compatibility between the homograft and recipient, decellularization, and glutaraldehyde treatment [3,18,19]. However, in this study the decellularized PH failed to show superiority over the regular PH regarding the prevention of conduit reoperation.…”

Challenges with sensitized recipients in pediatric heart transplantation

“…In patients with complex congenital heart disease, especially those with hypoplastic left heart syndrome, the avoidance of homografts or alterations of surgical materials to avoid antibody production may result in less sensitization (35). Because a number of these patients may require transplantation in the future due to a failing Fontan circulation, these precautions may decrease the risk of transplantation in this already high-risk, complex population.…”

A novel method for long-lasting preservation of arterial grafts

“…Another method of storage which, in contrast to cryopreservation, reduces the antigenicity is fixation in glutaraldehyde [18]. However, fixation in glutaraldehyde leads only to stabilization of collagen but no other components of the extracellular matrix, particularly elastin [19], which results in a low mechanical strength of transplanted arteries [20].…”