Living related liver transplantation across ABO blood groups.
We performed 13 pediatric liver transplants from ABO-incompatible living related maternal or paternal donors using a combination of preoperative removal of isohemagglutinin and postoperative immunosuppressive therapy with FK506 and prophylactic OKT3. Tissue near-infrared spectroscopy was applied to evaluate hemodynamics using the hemoglobin of red cells in the sinusoids as an index. The data obtained indicated that the preoperative removal of isohemagglutinin prevented hyperacute humoral rejection with hemorrhagic infiltration in the sinusoids in 10 successful cases. The incidence of acute rejection was not significantly different among ABO-identical, -compatible, and -incompatible groups. The estimated 1-year survival rate of the ABO-incompatible group was 77%.
Tanaka
A
A
Second Department of Surgery, Faculty of Medicine, Kyoto University, Japan.
Tanaka
K
K
Kitai
T
T
Yanabu
N
N
Tokuka
A
A
Sato
B
B
Mori
S
S
Inomoto
T
T
Shinohara
H
H
Uemoto
S
S
D000017:ABO Blood-Group System; D001775:Blood Circulation; D001778:Blood Coagulation Disorders / Q000276:immunology / Q000503:physiopathology; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000276:immunology; D006085:Graft Survival / Q000276:immunology; D006439:Hemodynamics; D006454:Hemoglobins / Q000276:immunology; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000276:immunology*; D008297:Male; D016853:Muromonab-CD3 / Q000627:therapeutic use; D013055:Spectrophotometry, Infrared / Q000379:methods; D016559:Tacrolimus / Q000627:therapeutic use; D014019:Tissue Donors
D000017:ABO Blood-Group System; D006454:Hemoglobins; D016853:Muromonab-CD3; D016559:Tacrolimus