title: Outcomes after identical and compatible orthotopic liver transplantation for fulminant hepatic failure: a single center experience in UK.
abstract: To analyze the outcomes between identical and compatible liver transplantation (OLT) for fulminant hepatic failure (FHF) from September 1984 to November 2005. The patients were divided in three groups; group 1 (identical), group 2 (compatible) and group 3 (incompatible), according to the donor-recipient blood type matching. We analyzed several outcomes regarding mortality, patient and graft survival, incidence of acute graft rejection during the first postoperative month (30 days), incidence of biliary complications and indications of re-transplantation. We also analyzed the relationship of Coomb's positive test with postoperative hemolysis to all the above mentioned factors. During the study period, 168 males and 112 females underwent their first OLT for FHF, with 37.1% overall mortality and 42.1% overall graft failure rate. The results between group 1 (203 patients) and group 2 (73 patients) were comparable. A statistically significant difference was recorded in 1 year and overall graft survival between group 1 and group 2 (P = 0.049 and log-rank = 0.035 respectively). Coomb's positive test did not influence the outcomes. OLT in FHF can be safely carried out whether the donor organs are identical or compatible. Hemolysis (Coomb's positive test) after identical or compatible OLT does not influence the outcomes.
authors.affiliation: Liver Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK.
authors.forename: Ilias
authors.initials: I
authors.lastname: Koukoutsis
authors.forename: Riccardo
authors.initials: R
authors.lastname: Bellagamba
authors.forename: Appou
authors.initials: A
authors.lastname: Tamijmarane
authors.forename: Bridget
authors.initials: B
authors.lastname: Gunson
authors.forename: Vijayaragavan
authors.initials: V
authors.lastname: Muralidharan
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Wigmore
authors.forename: David A
authors.initials: DA
authors.lastname: Mayer
authors.forename: Darius F
authors.initials: DF
authors.lastname: Mirza
authors.forename: John A C
authors.initials: JA
authors.lastname: Buckels
authors.forename: Simon R
authors.initials: SR
authors.lastname: Bramhall
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology*; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D017114:Liver Failure, Acute / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology