Liver transplantation across ABO blood group barriers.
In a study of 234 liver transplants the 2-year graft survival for ABO-compatible elective (80%) or emergency (76%) liver transplants was significantly higher than that for ABO-incompatible emergency liver transplants (30%). The low survival of ABO-incompatible liver allografts was therefore not related to the emergency conditions. Among 17 patients who received ABO-incompatible liver allografts, primary humoral rejection, with haemorrhagic infiltration of portal tracts and deposition of IgM and fibrinogen on sinusoidal and endothelial cells, developed in 6. Other disadvantages of ABO-incompatible liver allografts were significantly higher frequencies of severe rejection crises, arterial thrombosis, and cholangitis. However, the 1-year survival rate of the patients who received ABO-incompatible grafts was 66%, so the use of ABO-incompatible liver grafts is justifiable in emergencies, when no other donor is available; such transplants may help to save the patient, even at the cost of retransplantation in half of the cases.
Gugenheim
J
J
Hepatobiliary Surgery and Transplantation Research Unit, South-Paris Faculty of Medicine, Paul Brousse Hospital, Villejuif, France.
Samuel
D
D
Reynes
M
M
Bismuth
H
H
D000017:ABO Blood-Group System; D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D001787:Blood Group Incompatibility / Q000601:surgery*; D002648:Child; D004630:Emergencies; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008099:Liver / Q000473:pathology; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D011183:Postoperative Complications / Q000473:pathology; D012189:Retrospective Studies; D015996:Survival Rate
D000017:ABO Blood-Group System