title: Successful ABO-incompatible liver transplantation with pre- and postoperative plasmapheresis, triple immunosuppression, and splenectomy for fulminant hepatic failure.
abstract: Fulminant hepatic failure continues to be a challenge to hepatologists and surgeons. Because of the rapid deterioration in the clinical condition of patients with fulminant hepatic failure and the scarcity of available grafts, an ABO-incompatible liver donor may be the only choice for a patient with life-threatening hepatic insufficiency. Here, we report a patient with fulminant hepatic failure who received an ABO-incompatible liver transplantation who was treated with pre- and posttransplantation double-volume total plasma exchange, splenectomy, and triple immunosuppression (tacrolimus, mycophenolate mofetil, and prednisone) in July 2003. At 26 months' follow-up, the patient's postoperative course has been uneventful. Using protocols aimed at removing existing isohemagglutinins and reducing further antibody production, ABO-incompatible liver transplantation may be performed as a life-saving procedure in patients with fulminant hepatic failure.
authors.affiliation: Gulhane Military Medical Academy, Department of Surgery, Ankara, Turkey. gyagci@gata.edu.tr
authors.forename: Gokhan
authors.initials: G
authors.lastname: Yagci
authors.forename: Sadettin
authors.initials: S
authors.lastname: Cetiner
authors.forename: Cengizhan
authors.initials: C
authors.lastname: Yigitler
authors.forename: Alper
authors.initials: A
authors.lastname: Sonmez
authors.forename: M Refik
authors.initials: MR
authors.lastname: Mas
authors.forename: Ahmet
authors.initials: A
authors.lastname: Cosar
authors.forename: Aydin
authors.initials: A
authors.lastname: Dalgic
authors.forename: Munci
authors.initials: M
authors.lastname: Kalayoglu
mesh_terms: D000017:ABO Blood-Group System; D000328:Adult; D001787:Blood Group Incompatibility; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017114:Liver Failure, Acute / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D010956:Plasmapheresis; D013156:Splenectomy
chemical_list: D000017:ABO Blood-Group System; D007166:Immunosuppressive Agents