title: Role of apheresis and dialysis in pediatric living donor liver transplantation: a single center retrospective study.
abstract: In the field of pediatric living donor liver transplantation, the indications for apheresis and dialysis, and its efficacy and safety are still a matter of debate. In this study, we performed a retrospective investigation of these aspects, and considered its roles. Between January 2008 and December 2010, 73 living donor liver transplantations were performed in our department. Twenty seven courses of apheresis and dialysis were performed for 19 of those patients (19/73; 26.0%). The indications were ABO incompatible-liver transplantation in 11 courses, fluid management in seven, acute liver failure in three, renal replacement therapy in two, endotoxin removal in two, cytokine removal in one, and liver allograft dysfunction in one. Sixteen courses of apheresis and dialysis were performed prior to liver transplantation for 14 patients. The median IgM antibody titers before and after apheresis for ABO blood type-incompatible liver transplantation was 128 and eight, respectively (P < 0.05). Eleven courses of apheresis and dialysis were performed post liver transplantation for 10 patients. The median PaO2/FiO2 ratio before and after dialysis for fluid overload was 159 and 339, respectively (P < 0.05). No bleeding or technical complications attributable to apheresis and dialysis occurred. The 1-year survival rate of the patients was 100%. Apheresis and dialysis in pediatric living donor liver transplantation are effective for antibody removal in ABO-incompatible liver transplantation, and fluid management for acute respiratory failure.
authors: Department of Transplant Surgery, Jichi Medical University, Shimotsuke City, Tochigi, Japan. yuki371@jichi.ac.jp
authors: Yukihiro
authors: Y
authors: Sanada
authors: Koichi
authors: K
authors: Mizuta
authors: Taizen
authors: T
authors: Urahashi
authors: Yoshiyuki
authors: Y
authors: Ihara
authors: Taiichi
authors: T
authors: Wakiya
authors: Noriki
authors: N
authors: Okada
authors: Naoya
authors: N
authors: Yamada
authors: Toshitaka
authors: T
authors: Koinuma
authors: Kansuke
authors: K
authors: Koyama
authors: Shinichiro
authors: S
authors: Tanaka
authors: Kazuhide
authors: K
authors: Misawa
authors: Masahiko
authors: M
authors: Wada
authors: Shin
authors: S
authors: Nunomiya
authors: Yoshikazu
authors: Y
authors: Yasuda
authors: Hideo
authors: H
authors: Kawarasaki
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000293:Adolescent; D001781:Blood Component Removal / Q000379:methods*; D001787:Blood Group Incompatibility / Q000276:immunology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016031:Liver Transplantation / Q000276:immunology / Q000379:methods*; D019520:Living Donors; D008297:Male; D010372:Pediatrics; D006435:Renal Dialysis; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000017:ABO Blood-Group System