Paired donor interchange to avoid ABO-incompatible living donor liver transplantation.
We report an emergency paired donor interchange living donor liver transplant performed on January 13, 2009. The 4 operations (2 liver transplants) were performed simultaneously. The aim was to avoid 2 ABO-incompatible liver transplants. One recipient in acute liver failure underwent transplantation in a high-urgency situation. The abdomen of the other recipient had severe adhesions from previous spontaneous bacterial peritonitis that rendered the recipient operation almost impossible. The ethical and logistical issues are discussed. Approaches adopted in anticipation of potential adverse outcomes are explained in view of the higher donor and recipient mortality and morbidity rates in comparison with kidney transplantation.
Chan
See Ching
SC
Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
Lo
Chung Mau
CM
Yong
Boon Hun
BH
Tsui
Wilson J C
WJ
Ng
Kelvin K C
KK
Fan
Sheung Tat
ST
D000017:ABO Blood-Group System / Q000276:immunology*; D000293:Adolescent; D000328:Adult; D001787:Blood Group Incompatibility / Q000276:immunology*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008099:Liver / Q000276:immunology / Q000473:pathology; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D016896:Treatment Outcome
D000017:ABO Blood-Group System; D007166:Immunosuppressive Agents