title: A reassessment of ABO incompatibility in pediatric liver transplantation.
abstract: The present study examined 144 pediatric liver transplants to determine the impact of ABO matching on liver allograft outcome. Pediatric transplants were divided into 3 groups: ABO identical (ABO-Id; n = 108), ABO-compatible nonidentical (ABO-Comp; n = 22), and ABO incompatible (ABO-Inc; n = 14). A higher proportion of United Network for Organ Sharing status 4 recipients in the ABO-Comp group (50% vs. 22% and 36% for ABO-Id and ABO-Inc, P < 0.05) and less time spent on the waiting list for ABO-Inc recipients (46 +/- 12 vs. 87 +/- 11 and 61 +/- 20 days for ABO-Id and ABO-Comp, P < 0.01) were noted. OKT3 induction therapy was greater in ABO-Inc grafts (57% vs. 19% and 14% for ABO-Id and ABO-Comp, P < 0.05), as was incidence of acute cellular rejection (79% vs. 59% and 41% for ABO-Id and ABO-Comp, P = 0.08). One- and 3-year patient survival rates were 87% and 83% in the ABO-Id group, 95% and 88% in the ABO-Comp group, and 79% and 79% in the ABO-Inc group (P = NS). One- and 3-year graft survival rates were 83% and 78% in the ABO-Id group, 87% and 80% in the ABO-Comp group, and 71% and 71% in the ABO-Inc group (P = NS). ABO-Inc transplantations can be performed successfully in pediatric recipients and warrant a reassessment of the utilization of ABO-Inc livers.
authors.affiliation: Department of Surgery, Stanford University Medical Center, Palo Alto, California 94304, USA.
authors.forename: T V
authors.initials: TV
authors.lastname: Cacciarelli
authors.forename: S K
authors.initials: SK
authors.lastname: So
authors.forename: J
authors.initials: J
authors.lastname: Lim
authors.forename: W
authors.initials: W
authors.lastname: Concepcion
authors.forename: K
authors.initials: K
authors.lastname: Cox
authors.forename: C O
authors.initials: CO
authors.lastname: Esquivel
mesh_terms: D000017:ABO Blood-Group System; D001787:Blood Group Incompatibility / Q000175:diagnosis*; D002675:Child, Preschool; D005500:Follow-Up Studies; D006085:Graft Survival / Q000276:immunology; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007223:Infant; D016031:Liver Transplantation / Q000276:immunology*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000017:ABO Blood-Group System