Results of ABO-Incompatible Liver Transplantation Using a Simplified Protocol at a Single Institution

Lee, J.; Lee, J.J.; Kim, M.S.; Ju, Man Ki; Choi, Gi Hong; Choi, Jin Sub; Kim, S.I.; Joo, Dong Jin

doi:10.1016/j.transproceed.2015.02.004

Cited by 22 publications

(18 citation statements)

References 17 publications

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“…Other authors describe AB0i LDLT in patients with HBV or HCV cirrhosis and in patients with HCC, as well. Unfortunately, they provide no information about their hepatitis therapy or antibiosis (Table 1 )[ 20 , 35 , 36 ]. No data are available on AB0i LDLT in HCV patients with the new antivirals.…”

Section: Indications For Ab0i Ldlt With Special Reflexionsmentioning

confidence: 99%

Current techniques for AB0-incompatible living donor liver transplantation

Rummler¹,

Bauschke²,

Barthel³

et al. 2016

WJT

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For a long time, it was considered medical malpractice to neglect the blood group system during transplantation. Because there are far more patients waiting for organs than organs available, a variety of attempts have been made to transplant AB0-incompatible (AB0i) grafts. Improvements in AB0i graft survival rates have been achieved with immunosuppression regimens and plasma treatment procedures. Nevertheless, some grafts are rejected early after AB0i living donor liver transplantation (LDLT) due to antibody mediated rejection or later biliary complications that affect the quality of life. Therefore, the AB0i LDLT is an option only for emergency situations, and it requires careful planning. This review compares the treatment possibilities and their effect on the patients’ graft outcome from 2010 to the present. We compared 11 transplant center regimens and their outcomes. The best improvement, next to plasma treatment procedures, has been reached with the prophylactic use of rituximab more than one week before AB0i LDLT. Unfortunately, no standardized treatment protocols are available. Each center treats its patients with its own scheme. Nevertheless, the transplant results are homogeneous. Due to refined treatment strategies, AB0i LDLT is a feasible option today and almost free of severe complications.

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Section: Indications For Ab0i Ldlt With Special Reflexionsmentioning

confidence: 99%

Current techniques for AB0-incompatible living donor liver transplantation

Rummler¹,

Bauschke²,

Barthel³

et al. 2016

WJT

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“…Therefore, rituximab acts as a form of chemical splenectomy [22]. Studies have shown that preoperative administration of rituximab may replace splenectomy [19,23,24]. Considering this benefit of rituximab in terms of spleen preservation, embolization of a splenic artery aneurysm was performed to preserve the spleen before transplantation.…”

Section: Discussionmentioning

confidence: 99%

ABO-incompatible living donor liver transplantation in a patient with a history of platelet transfusion-related anaphylaxis

Chang¹,

Han²,

Cho³

et al. 2016

Arch Clin Gastroenterol

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Anaphylaxis and severe allergic transfusion reactions (ATR) are uncommon complications after blood transfusion. Nevertheless, these complications are associated with very severe outcomes, such as dyspnea, shock, and death. Patients with end-stage liver disease who require liver transplantation have a high tendency for bleeding because of splenomegaly-induced thrombocytopenia and decreased production of coagulation factors in the liver. Liver transplantation is a very long procedure and a significant perioperative blood loss is highly likely. Therefore, transfusion of platelets and other blood products is often necessary. We report a successful ABO-incompatible living donor liver transplantation in a patient with hepatitis B virus-related liver cirrhosis and hepatocellular carcinoma who had a history of platelet transfusion-related anaphylaxis.

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“…It has been proposed to include the blocking of Fc receptors to non-nuclear cells, direct antibody neutralization, suppression of CD19 presentation to activated B cells, suppression of complements, and suppression of all porous T cells. [17][18][19] Several previous studies have reported on the effectiveness of additional IVIG for preventing AMR. Kim et al had reported that the combination of rituximab, plasmapheresis, and IVIG had excellent results.…”

Section: Ivigmentioning

confidence: 99%

“…24 Since the rituximab era, many centers are now trying to simplify the protocol, and avoid splenectomy, local graft infusion, IVIG, and plasmapheresis. [14][15][16][17][18][19][20]…”

Section: Rituximabmentioning

confidence: 99%

Immunologic strategies and outcomes in ABO-incompatible living donor liver transplantation

Kim

2020

Clin Mol Hepatol

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In the past, adult ABO incompatible living donor liver transplantation (ABO-I LDLT) had poor graft survival and low patient survival due to hyperacute rejection and a high risk of vascular biliary complication, and it was considered a contraindication. 1-4 Susceptibility to rejection, including severe hepatic necrosis and diffuse intravascular coagulation disorder within the graft, appears to be due to the blood group antigen expressed in the vascular endothelium and bile ducts after transplantation. 5,6 Various desensitization strategies have been introduced to overcome the barrier of ABO incompatibility. 7-9 However, desensitization protocols differ at each center, and the necessity of local infusion, splenectomy, intravenous immunoglobulin (IVIG), and plasmapheresis is controversial. After the rituximab era, the outcome of ABO-I LDLT has been reported in many studies to be comparable to ABO compatible living donor liver transplantation (ABO-C LDLT). 10-13 Many centers are now trying to simplify protocols. 14-20 We review the past and current immune strategies for desensitization and to provide outcomes and ABO incompatibility-related complications in ABO-I LDLT.

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Results of ABO-Incompatible Liver Transplantation Using a Simplified Protocol at a Single Institution

Cited by 22 publications

References 17 publications

Current techniques for AB0-incompatible living donor liver transplantation

Current techniques for AB0-incompatible living donor liver transplantation

ABO-incompatible living donor liver transplantation in a patient with a history of platelet transfusion-related anaphylaxis

Immunologic strategies and outcomes in ABO-incompatible living donor liver transplantation

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