title: Successful experiences of ABO-incompatible adult living donor liver transplantation in a single institute: no immunological failure in 10 consecutive cases.
abstract: ABO-incompatible (ABOi) adult living donor liver transplantation (ALDLT) is a feasible therapeutic option for countries with a scarcity of deceased donors. This report presents our initial experiences in ABOi ALDLT in 10 patients between December 2008 and September 2009. The mean age of recipients was 48.5 ± 5.7 years (range, 40-54 years). The mean Model for End-stage Liver-Disease score was 13.9 ± 4.0 (range, 9-22). All patients were administered preoperative rituximab once and plasma exchanges according to the hemagglutinin titer. The spleen was preserved in all cases. For local infusion therapy, hepatic arterial infusion was performed in 9 patients and portal vein infusion in 1 subject. The 10 patients experienced no in-hospital mortality. At a mean follow-up period of 31.8 ± 2.9 months (range, 4.1-34.9 months), 1 patient has died (postoperative month 4 due to sepsis following a biliary stricture. The 3-month patient and graft survivals were 100%, and 1- and 2-year survivals, 90.0%. There was no episode of antibody-mediated rejection. The promising results of our initial experience may have been due to the use of preoperative rituximab and the good preoperative conditions of the patients.
authors: Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea. drsong71@amc.seoul.kr
authors: G-W
authors: GW
authors: Song
authors: S-G
authors: SG
authors: Lee
authors: S
authors: S
authors: Hwang
authors: C-S
authors: CS
authors: Ahn
authors: D-B
authors: DB
authors: Moon
authors: K-H
authors: KH
authors: Kim
authors: T-Y
authors: TY
authors: Ha
authors: D-H
authors: DH
authors: Jung
authors: G-C
authors: GC
authors: Park
authors: J-M
authors: JM
authors: Namgung
authors: C-S
authors: CS
authors: Park
authors: H-W
authors: HW
authors: Park
authors: Y-H
authors: YH
authors: Park
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D001787:Blood Group Incompatibility / Q000188:drug therapy* / Q000276:immunology*; D006528:Carcinoma, Hepatocellular / Q000628:therapy; D058625:End Stage Liver Disease / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006509:Hepatitis B / Q000628:therapy; D006801:Humans; D008103:Liver Cirrhosis / Q000628:therapy; D008113:Liver Neoplasms / Q000628:therapy; D019520:Living Donors; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011788:Quality of Life; D000069283:Rituximab; D016896:Treatment Outcome
chemical_list: D000017:ABO Blood-Group System; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D008775:Methylprednisolone