title: Liver transplantation with ABO incompatible graft under immunoadsorption protocol--case report.
abstract: BACKGROUND
  ABO incompatible liver transplantation is still controversial, but accepted in selected cases. Recently several authors reported use of the new technology aimed at elimination anti-donor ABO specific hemagglutinins to assist immunosuppression in preventing acute rejection after transplantation.
  
  
  METHODS
  We report two cases of liver transplantation in children with ABO incompatible graft under immunoadsorption protocol. Both patients were transplanted urgently (one due to acute decompensation of chronic liver failure and second due to acute liver failure) with ABO incompatible liver grafts. Both patients were in very poor general condition with deterioration of neurological status and there were no suitable ABO compatible grafts at the time. In both cases immunosuppressive protocol consisted of induction with basiliximab, followed by tacrolimus, mycophenolate mofetil and corticosteroids. Additionally in both patients 3 immunoadsorption sessions with Glycosorb ABO® system (Glycorex AB, Sweden), were performed. There were no any acute rejection episodes till now. The only problem observed after transplantation was mild anemia due to low grade hemolysis in the postoperative period. Both patients are alive and well with very good liver function 20 and 26 months after transplantation.
  
  
  CONCLUSIONS
  Immunoadsorption therapy can be safely and effectively introduced in recipients of ABO incompatible donor liver.
authors.affiliation: Department of Pediatric Surgery and Organ Transplantation, Children's Memorial Health Institute, Warsaw, Poland. gonia.mark@wp.pl
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Markiewicz-Kijewska
authors.forename: Piotr
authors.initials: P
authors.lastname: Kaliciński
authors.forename: Joanna
authors.initials: J
authors.lastname: Teisseyre
authors.forename: Hor
authors.initials: H
authors.lastname: Ismail
authors.forename: Anna
authors.initials: A
authors.lastname: Ostoja-Chyzyńska
authors.forename: Sylwester
authors.initials: S
authors.lastname: Prokurat
authors.forename: Irena
authors.initials: I
authors.lastname: Sokolnicka
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000293:Adolescent; D001787:Blood Group Incompatibility; D002985:Clinical Protocols; D058625:End Stage Liver Disease / Q000601:surgery; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology*; D006801:Humans; D007163:Immunosorbent Techniques; D017114:Liver Failure, Acute / Q000601:surgery; D016031:Liver Transplantation / Q000276:immunology*; D008297:Male; D016896:Treatment Outcome
chemical_list: D000017:ABO Blood-Group System