Successful ABO-incompatible liver transplantation with pre- and postoperative plasmapheresis, triple immunosuppression, and splenectomy for fulminant hepatic failure.
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.
Yagci
Gokhan
G
Gulhane Military Medical Academy, Department of Surgery, Ankara, Turkey. gyagci@gata.edu.tr
Cetiner
Sadettin
S
Yigitler
Cengizhan
C
Sonmez
Alper
A
Mas
M Refik
MR
Cosar
Ahmet
A
Dalgic
Aydin
A
Kalayoglu
Munci
M
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
D000017:ABO Blood-Group System; D007166:Immunosuppressive Agents